- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.27 / $4.25 / $4.82
| Facility | | $3.27 | $4.25 | $4.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.21 / $4.30 / $5.74
| Professional | | $3.21 | $4.30 | $5.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.93 / $7.25 / $18.30
| Facility | | $3.93 | $7.25 | $18.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.12 / $3.12 / $3.50
| Professional | | $3.12 | $3.12 | $3.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4.91 / $4.91 / $6.55
| Facility | | $4.91 | $4.91 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.55 / $6.55 / $6.55
| Facility | | $6.55 | $6.55 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.94 / $3.94 / $3.94
| Facility | | $3.94 | $3.94 | $3.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.35 / $4.63
| Professional | | $3.35 | $3.35 | $4.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.61 / $32.61 / $49.13
| Professional | | $32.61 | $32.61 | $49.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.79 / $4.82 / $6.55
| Facility | | $1.79 | $4.82 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.01 / $5.90 / $6.55
| Professional | | $4.01 | $5.90 | $6.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.79 / $4.68 / $6.55
| Facility | | $1.79 | $4.68 | $6.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.35 / $3.35 / $5.45
| Professional | | $3.35 | $3.35 | $5.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $3.02 / $3.98
| Professional | | $2.31 | $3.02 | $3.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.18 / $4.18 / $6.55
| Professional | | $4.18 | $4.18 | $6.55 |