- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $2.48 / $3.72
| Facility | | $2.31 | $2.48 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.14 / $2.48 / $2.64
| Professional | | $2.14 | $2.48 | $2.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.14 / $2.14 / $2.67
| Facility | | $2.14 | $2.14 | $2.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.59 / $2.59
| Professional | | $2.39 | $2.59 | $2.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.62 / $1.62 / $1.78
| Facility | | $1.62 | $1.62 | $1.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.62 / $1.62 / $1.62
| Professional | | $1.62 | $1.62 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.02 / $2.09 / $2.64
| Facility | | $2.02 | $2.09 | $2.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $2.64
| Professional | | $2.64 | $2.64 | $2.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $4.57
| Facility | | $2.64 | $2.64 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $3.04
| Professional | | $2.64 | $2.64 | $3.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $2.74 / $2.74
| Facility | | $2.64 | $2.74 | $2.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $2.74 / $2.74
| Professional | | $2.64 | $2.74 | $2.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.09 / $2.09 / $597.00
| Facility | | $2.09 | $2.09 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $3.82
| Professional | | $2.64 | $2.64 | $3.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.59 / $2.59 / $3.74
| Professional | | $2.59 | $2.59 | $3.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.64 / $2.64 / $2.64
| Facility | | $2.64 | $2.64 | $2.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.60 / $2.64 / $2.74
| Professional | | $0.60 | $2.64 | $2.74 |