- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.39 / $13.90 / $22.78
| Facility | | $11.39 | $13.90 | $22.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $15.38
| Professional | | $13.06 | $13.06 | $15.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.00 / $13.06 / $25.82
| Professional | | $13.00 | $13.06 | $25.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.14 / $14.14 / $14.85
| Facility | | $14.14 | $14.14 | $14.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.14 / $14.14 / $14.14
| Professional | | $14.14 | $14.14 | $14.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $12.32 / $17.37
| Facility | | $12.32 | $12.32 | $17.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $13.06
| Professional | | $13.06 | $13.06 | $13.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $18.48 / $332.00
| Facility | | $12.32 | $18.48 | $332.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.17 / $14.17 / $34.25
| Professional | | $14.17 | $14.17 | $34.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $13.55
| Facility | | $13.06 | $13.06 | $13.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $13.55
| Professional | | $13.06 | $13.06 | $13.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.32 / $12.32 / $555.00
| Facility | | $12.32 | $12.32 | $555.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $13.39 / $34.00
| Professional | | $13.06 | $13.39 | $34.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $13.06 / $33.00
| Professional | | $13.06 | $13.06 | $33.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.55 / $13.55 / $13.55
| Facility | | $13.55 | $13.55 | $13.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.93 / $13.06 / $20.99
| Professional | | $12.93 | $13.06 | $20.99 |