- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.05 / $25.83 / $104.11
| Facility | | $14.05 | $25.83 | $104.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.32 / $16.38 / $59.20
| Professional | | $13.32 | $16.38 | $59.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.43 / $13.43 / $18.94
| Professional | | $13.43 | $13.43 | $18.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.57 / $11.57 / $11.57
| Facility | | $11.57 | $11.57 | $11.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.57 / $11.57 / $11.57
| Professional | | $11.57 | $11.57 | $11.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.35 / $13.75 / $51.71
| Facility | | $13.35 | $13.75 | $51.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.75 / $14.75 / $14.75
| Professional | | $14.75 | $14.75 | $14.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.09 / $14.09 / $28.88
| Facility | | $14.09 | $14.09 | $28.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.09 / $14.09 / $16.20
| Professional | | $14.09 | $14.09 | $16.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.82 / $13.82 / $13.82
| Facility | | $13.82 | $13.82 | $13.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.82 / $13.82 / $14.87
| Professional | | $13.82 | $13.82 | $14.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.30 / $17.22 / $44.28
| Facility | | $13.30 | $17.22 | $44.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.91 / $16.57 / $17.22
| Professional | | $15.91 | $16.57 | $17.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.75 / $13.75 / $597.00
| Facility | | $13.75 | $13.75 | $597.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.75 / $34.00 / $34.00
| Professional | | $14.75 | $34.00 | $34.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.29 / $15.68 / $19.73
| Professional | | $13.29 | $15.68 | $19.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.82 / $13.82 / $22.87
| Facility | | $13.82 | $13.82 | $22.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.82 / $14.87 / $26.74
| Professional | | $13.82 | $14.87 | $26.74 |