- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $1.42 / $4.07
| Facility | | $1.42 | $1.42 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.42 / $2.10 / $4.68
| Professional | | $1.42 | $2.10 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $4.04
| Facility | | $2.45 | $2.45 | $4.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.27 / $2.45 / $2.79
| Professional | | $2.27 | $2.45 | $2.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.45 / $5.24 / $5.24
| Facility | | $2.45 | $5.24 | $5.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.31 / $7.37 / $9.80
| Facility | | $6.31 | $7.37 | $9.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $3.75 / $4.63
| Professional | | $1.25 | $3.75 | $4.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $2.04 / $4.50
| Facility | | $1.42 | $2.04 | $4.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Professional | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $2.02 / $5.51
| Facility | | $1.42 | $2.02 | $5.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.15 / $1.38 / $12.20
| Professional | | $1.15 | $1.38 | $12.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.72 / $65.00 / $85.00
| Professional | | $0.72 | $65.00 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.42 / $2.04 / $5.51
| Facility | | $1.42 | $2.04 | $5.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Professional | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $3.68 / $6.00
| Professional | | $2.45 | $3.68 | $6.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.97 / $8.16 / $90.00
| Facility | | $4.97 | $8.16 | $90.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.25 / $10.76 / $12.20
| Professional | | $1.25 | $10.76 | $12.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Professional | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.45 / $2.45 / $2.45
| Professional | | $2.45 | $2.45 | $2.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.03 / $1.22 / $2.27
| Professional | | $1.03 | $1.22 | $2.27 |