- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.33 / $1.76 / $1.90
| Facility | | $1.33 | $1.76 | $1.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.17 / $1.76 / $2.34
| Professional | | $1.17 | $1.76 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $3.03 / $7.36
| Facility | | $2.00 | $3.03 | $7.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.27 / $1.27 / $1.27
| Professional | | $1.27 | $1.27 | $1.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.67 / $2.21 / $2.67
| Facility | | $1.67 | $2.21 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.00
| Professional | | $2.00 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.62 / $1.62 / $3.13
| Facility | | $1.62 | $1.62 | $3.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $1.38 / $1.38
| Professional | | $1.38 | $1.38 | $1.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.42 / $80.00 / $85.00
| Facility | | $5.42 | $80.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.30 / $13.30 / $20.03
| Professional | | $13.30 | $13.30 | $20.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.76 / $2.11 / $3.35
| Facility | | $1.76 | $2.11 | $3.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.54 / $2.67
| Professional | | $2.14 | $2.54 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.07 / $5.30
| Professional | | $2.00 | $3.07 | $5.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $2.11 / $3.36
| Facility | | $1.78 | $2.11 | $3.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $1.38 / $2.23
| Professional | | $1.38 | $1.38 | $2.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.95 / $1.24 / $1.63
| Professional | | $0.95 | $1.24 | $1.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.19 / $2.67 / $3.60
| Professional | | $1.19 | $2.67 | $3.60 |