- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $3.23 / $5.49
| Facility | | $2.65 | $3.23 | $5.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $3.58
| Professional | | $2.66 | $2.66 | $3.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.13 / $2.13 / $2.66
| Facility | | $2.13 | $2.13 | $2.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.66 / $3.49
| Professional | | $2.41 | $2.66 | $3.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $2.43
| Facility | | $2.31 | $2.31 | $2.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.31 / $2.31 / $2.31
| Professional | | $2.31 | $2.31 | $2.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.50 / $2.65
| Facility | | $2.40 | $2.50 | $2.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.65 / $2.65
| Professional | | $2.65 | $2.65 | $2.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $3.75 / $332.00
| Facility | | $2.50 | $3.75 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.76 / $2.76 / $3.57
| Professional | | $2.76 | $2.76 | $3.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $2.71
| Facility | | $2.66 | $2.66 | $2.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $2.71
| Professional | | $2.66 | $2.66 | $2.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.50 / $555.00
| Facility | | $2.40 | $2.50 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.54 / $2.65 / $3.52
| Professional | | $2.54 | $2.65 | $3.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $3.57
| Professional | | $2.66 | $2.66 | $3.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.71 / $2.71 / $2.71
| Facility | | $2.71 | $2.71 | $2.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.43 / $2.66 / $2.71
| Professional | | $1.43 | $2.66 | $2.71 |