- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.12 / $4.05 / $61.85
| Facility | | $3.12 | $4.05 | $61.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.25 / $3.29 / $6.98
| Professional | | $3.25 | $3.29 | $6.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.61 / $2.61 / $3.26
| Facility | | $2.61 | $2.61 | $3.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.89 / $3.26 / $5.31
| Professional | | $2.89 | $3.26 | $5.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.83 / $2.83 / $2.97
| Facility | | $2.83 | $2.83 | $2.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.83 / $2.83 / $2.83
| Professional | | $2.83 | $2.83 | $2.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $3.08 / $3.60
| Facility | | $3.02 | $3.08 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.26
| Professional | | $3.26 | $3.26 | $3.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.54 / $5.08 / $332.00
| Facility | | $3.54 | $5.08 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.39 / $3.54 / $4.08
| Professional | | $3.39 | $3.54 | $4.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.38
| Facility | | $3.26 | $3.26 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.38 / $3.38
| Professional | | $3.26 | $3.38 | $3.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.55 / $3.55 / $3.55
| Facility | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.02 / $3.08 / $3.60
| Facility | | $3.02 | $3.08 | $3.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.26 / $3.69
| Professional | | $3.26 | $3.26 | $3.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.22 / $3.44 / $4.37
| Professional | | $3.22 | $3.44 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.38 / $3.38 / $3.38
| Facility | | $3.38 | $3.38 | $3.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.26 / $3.38 / $3.38
| Professional | | $3.26 | $3.38 | $3.38 |