- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.65 / $6.20 / $8.06
| Facility | | $2.65 | $6.20 | $8.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.67 / $5.29
| Professional | | $2.65 | $2.67 | $5.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.44 / $2.87 / $8,639.91
| Facility | | $2.44 | $2.87 | $8,639.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.75 / $2.75 / $2.75
| Professional | | $2.75 | $2.75 | $2.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.65 / $2.65
| Facility | | $2.50 | $2.65 | $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
- $2.68 / $5.27 / $8.06
| Facility | | $2.68 | $5.27 | $8.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.68 / $8.06
| Professional | | $2.65 | $2.68 | $8.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.50 / $2.65 / $2.65
| Facility | | $2.50 | $2.65 | $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
- $2.17 / $2.17 / $2.52
| Facility | | $2.17 | $2.17 | $2.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.17 / $2.17 / $2.52
| Professional | | $2.17 | $2.17 | $2.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.65 / $2.65 / $3.66
| Professional | | $2.65 | $2.65 | $3.66 |