- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.89 / $14.89 / $15.17
| Facility | | $14.89 | $14.89 | $15.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.89 / $15.17 / $15.17
| Professional | | $14.89 | $15.17 | $15.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.67 / $14.87 / $14.87
| Professional | | $13.67 | $14.87 | $14.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $14.31
| Facility | | $13.01 | $13.01 | $14.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.01 / $13.01 / $13.01
| Professional | | $13.01 | $13.01 | $13.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.10 / $14.52 / $16.64
| Facility | | $14.10 | $14.52 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.64 / $16.64 / $16.64
| Professional | | $16.64 | $16.64 | $16.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.07 / $16.07 / $27.80
| Facility | | $16.07 | $16.07 | $27.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.66 / $16.07 / $16.07
| Professional | | $13.66 | $16.07 | $16.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.17 / $15.77 / $15.77
| Facility | | $15.17 | $15.77 | $15.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.17 / $15.77 / $15.77
| Professional | | $15.17 | $15.77 | $15.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.52 / $14.52 / $597.00
| Facility | | $14.52 | $14.52 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.00 / $16.00 / $16.64
| Professional | | $16.00 | $16.00 | $16.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.32 / $18.38 / $23.60
| Professional | | $15.32 | $18.38 | $23.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.00 / $15.17 / $15.17
| Facility | | $12.00 | $15.17 | $15.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.06 / $12.00 / $15.77
| Professional | | $10.06 | $12.00 | $15.77 |