- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.44 / $4.68 / $5.51
| Facility | | $2.44 | $4.68 | $5.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.44 / $4.12
| Professional | | $2.37 | $2.44 | $4.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.96 / $4.38 / $5.29
| Facility | | $2.96 | $4.38 | $5.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $3.00
| Professional | | $2.37 | $2.37 | $3.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.25 / $3.25 / $3.79
| Facility | | $3.25 | $3.25 | $3.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $5.54 / $7.92
| Facility | | $2.37 | $5.54 | $7.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.44 / $3.17 / $3.60
| Professional | | $2.44 | $3.17 | $3.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $2.40 / $4.99
| Facility | | $2.37 | $2.40 | $4.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $4.74 / $4.74
| Professional | | $3.60 | $4.74 | $4.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $4.99
| Facility | | $2.40 | $2.40 | $4.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.40 / $2.40 / $4.74
| Professional | | $2.40 | $2.40 | $4.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.39 / $2.39 / $85.00
| Professional | | $2.39 | $2.39 | $85.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.37 / $2.40 / $4.99
| Facility | | $2.37 | $2.40 | $4.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.60 / $4.74 / $4.74
| Professional | | $3.60 | $4.74 | $4.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $3.70 / $7.70
| Professional | | $2.37 | $3.70 | $7.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $85.00 / $85.00
| Facility | | $85.00 | $85.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $2.37
| Professional | | $2.37 | $2.37 | $2.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.33 / $3.33 / $3.33
| Professional | | $3.33 | $3.33 | $3.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.37 / $2.37 / $3.25
| Professional | | $2.37 | $2.37 | $3.25 |