- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.07 / $1.50 / $2.56
| Facility | | $1.07 | $1.50 | $2.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.71 / $1.26 / $2.31
| Professional | | $0.71 | $1.26 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.09 / $1.09 / $3.93
| Professional | | $1.09 | $1.09 | $3.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.90 / $2.04 / $2.04
| Facility | | $1.90 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.04 / $2.04 / $2.04
| Professional | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $2.87
| Facility | | $2.87 | $2.87 | $2.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.25 / $1.25
| Professional | | $1.25 | $1.25 | $1.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $4.48 / $332.00
| Facility | | $2.45 | $4.48 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $3.31 / $5.32
| Professional | | $2.45 | $3.31 | $5.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.09 / $0.09 / $1.41
| Facility | | $0.09 | $0.09 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.09 / $1.41 / $1.50
| Professional | | $0.09 | $1.41 | $1.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.87 / $2.87 / $597.00
| Facility | | $2.87 | $2.87 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $1.25 / $4.20
| Professional | | $1.25 | $1.25 | $4.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.82 / $1.38 / $2.65
| Professional | | $0.82 | $1.38 | $2.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $1.75
| Facility | | $1.41 | $1.41 | $1.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.09 / $1.41 / $1.50
| Professional | | $0.09 | $1.41 | $1.50 |