- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.23 / $3.02 / $3.98
| Professional | | $1.23 | $3.02 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.31 / $0.31 / $0.56
| Facility | | $0.31 | $0.31 | $0.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.25 / $0.25 / $0.31
| Professional | | $0.25 | $0.25 | $0.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.25 / $0.83 / $1.45
| Facility | | $0.25 | $0.83 | $1.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.26 / $0.33 / $0.46
| Professional | | $0.26 | $0.33 | $0.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.28 / $0.28 / $0.71
| Facility | | $0.28 | $0.28 | $0.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.42 / $0.56 / $0.56
| Professional | | $0.42 | $0.56 | $0.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.30 / $0.30 / $1,258.93
| Facility | | $0.30 | $0.30 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.30 / $0.33 / $0.56
| Professional | | $0.30 | $0.33 | $0.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.25 / $64.57 / $85.11
| Professional | | $0.25 | $64.57 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.24 / $0.26 / $1.07
| Professional | | $0.24 | $0.26 | $1.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.25 / $0.25 / $85.11
| Facility | | $0.25 | $0.25 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.25 / $0.25 / $0.25
| Professional | | $0.25 | $0.25 | $0.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.34 / $0.34 / $0.72
| Professional | | $0.34 | $0.34 | $0.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.25 / $0.37 / $0.37
| Facility | | $0.25 | $0.37 | $0.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.25 / $0.28 / $0.38
| Professional | | $0.25 | $0.28 | $0.38 |