- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.29 / $2.62 / $114.38
| Facility | | $2.29 | $2.62 | $114.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.46 / $2.67
| Professional | | $2.13 | $2.46 | $2.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.12 / $1.12 / $1.41
| Facility | | $1.12 | $1.12 | $1.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.50 / $2.57 / $2.57
| Professional | | $2.50 | $2.57 | $2.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.63 / $3.63 / $3.99
| Facility | | $3.63 | $3.63 | $3.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.63 / $3.63 / $3.63
| Professional | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.45 / $1.50 / $2.62
| Facility | | $1.45 | $1.50 | $2.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $2.62
| Professional | | $2.62 | $2.62 | $2.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.33 / $2.86 / $332.00
| Facility | | $1.33 | $2.86 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.13 / $2.70 / $2.70
| Professional | | $2.13 | $2.70 | $2.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $3.82
| Facility | | $2.66 | $2.66 | $3.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.66 / $2.66 / $3.82
| Professional | | $2.66 | $2.66 | $3.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.50 / $1.50 / $597.00
| Facility | | $1.50 | $1.50 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.62 / $2.62 / $5.45
| Professional | | $2.62 | $2.62 | $5.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.57 / $2.57 / $4.01
| Professional | | $2.57 | $2.57 | $4.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.64 / $3.82 / $3.82
| Facility | | $0.64 | $3.82 | $3.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.47 / $0.64 / $3.82
| Professional | | $0.47 | $0.64 | $3.82 |