- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.41 / $1.41 / $7.36
| Facility | | $1.41 | $1.41 | $7.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.12 / $1.41 / $7.36
| Professional | | $1.12 | $1.41 | $7.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.07 / $3.89 / $8.06
| Facility | | $1.07 | $3.89 | $8.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.32 / $1.41 / $2.45
| Professional | | $1.32 | $1.41 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.62 / $3.69 / $5.49
| Facility | | $2.62 | $3.69 | $5.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.38 / $5.46 / $9.55
| Professional | | $1.38 | $5.46 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.02 / $2.08 / $2.08
| Facility | | $2.02 | $2.08 | $2.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $1.77 / $2.14
| Professional | | $1.77 | $1.77 | $2.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.02 / $2.54 / $3.05
| Professional | | $2.02 | $2.54 | $3.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.52 / $1.78 / $3.94
| Professional | | $1.52 | $1.78 | $3.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.25 / $13.25 / $19.05
| Professional | | $13.25 | $13.25 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $5.43 / $5.43
| Professional | | $5.43 | $5.43 | $5.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.76 / $2.25 / $2.65
| Facility | | $0.76 | $2.25 | $2.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.77 / $2.08 / $2.42
| Professional | | $1.77 | $2.08 | $2.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.80 / $4.80 / $4.80
| Professional | | $4.80 | $4.80 | $4.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.91 / $1.54 / $1.81
| Facility | | $0.91 | $1.54 | $1.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.10 / $1.27 / $2.43
| Professional | | $1.10 | $1.27 | $2.43 |