- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.99 / $4.90
| Facility | | $2.41 | $2.99 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $3.31
| Professional | | $2.41 | $2.41 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.93 / $1.93 / $2.41
| Facility | | $1.93 | $1.93 | $2.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.23 / $2.41 / $3.37
| Professional | | $2.23 | $2.41 | $3.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.20 / $2.20 / $2.31
| Facility | | $2.20 | $2.20 | $2.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.20 / $2.20 / $2.20
| Professional | | $2.20 | $2.20 | $2.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.27 / $2.41
| Facility | | $2.23 | $2.27 | $2.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.41
| Professional | | $2.41 | $2.41 | $2.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.27 / $3.42 / $332.00
| Facility | | $2.27 | $3.42 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $3.43
| Professional | | $2.62 | $2.62 | $3.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.50
| Facility | | $2.41 | $2.41 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $2.50
| Professional | | $2.41 | $2.41 | $2.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.23 / $2.27 / $555.00
| Facility | | $2.23 | $2.27 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.36 / $2.41 / $3.29
| Professional | | $2.36 | $2.41 | $3.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $2.41 / $3.38
| Professional | | $2.41 | $2.41 | $3.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.50 / $2.50
| Facility | | $2.50 | $2.50 | $2.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.64 / $2.41 / $2.50
| Professional | | $1.64 | $2.41 | $2.50 |