- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.04 / $3.02 / $6.03
| Facility | | $2.04 | $3.02 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $3.31
| Professional | | $2.00 | $2.00 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.51 / $2.51 / $4.47
| Facility | | $2.51 | $2.51 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.51
| Professional | | $2.00 | $2.00 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $2.40 / $5.75
| Facility | | $2.00 | $2.40 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.09 / $3.72
| Professional | | $2.00 | $2.09 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.86 / $1.86 / $2.14
| Facility | | $1.86 | $1.86 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.78 / $3.72 / $6.31
| Professional | | $1.78 | $3.72 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.55 / $1.55 / $2.24
| Facility | | $1.55 | $1.55 | $2.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.55 / $1.55 / $7.08
| Professional | | $1.55 | $1.55 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.47 / $58.88 / $70.79
| Professional | | $3.47 | $58.88 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $3.80 / $6.92
| Professional | | $2.00 | $3.80 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $85.11
| Facility | | $2.00 | $2.00 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.45 / $7.94
| Professional | | $2.00 | $2.45 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.69 / $2.69 / $3.31
| Professional | | $2.69 | $2.69 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.78 / $1.78 / $2.00
| Facility | | $1.78 | $1.78 | $2.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.00 / $2.00 / $2.29
| Professional | | $2.00 | $2.00 | $2.29 |