- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.57 / $0.63 / $6.21
| Facility | | $0.57 | $0.63 | $6.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.57 / $1.00 / $6.21
| Professional | | $0.57 | $1.00 | $6.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.67 / $0.80 / $1.35
| Facility | | $0.67 | $0.80 | $1.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.57 / $0.92 / $1.99
| Professional | | $0.57 | $0.92 | $1.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.25 / $3.16 / $4.54
| Facility | | $2.25 | $3.16 | $4.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $5.44 / $8.05
| Professional | | $2.50 | $5.44 | $8.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.10 / $1.10
| Professional | | $1.10 | $1.10 | $1.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.35 / $2.89
| Professional | | $2.14 | $2.35 | $2.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.00 / $2.68 / $4.92
| Professional | | $1.00 | $2.68 | $4.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.34 / $80.00 / $85.00
| Facility | | $4.34 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.66 / $10.66 / $16.05
| Professional | | $10.66 | $10.66 | $16.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.53 / $2.14 / $3.01
| Facility | | $1.53 | $2.14 | $3.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.10 / $2.35
| Professional | | $1.10 | $1.10 | $2.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.05 / $4.05 / $4.05
| Professional | | $4.05 | $4.05 | $4.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.41 / $1.56 / $1.93
| Professional | | $1.41 | $1.56 | $1.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.86 / $0.97 / $3.13
| Professional | | $0.86 | $0.97 | $3.13 |