- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.22 / $17.05 / $28.36
| Facility | | $14.22 | $17.05 | $28.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $14.31 / $17.04
| Professional | | $14.31 | $14.31 | $17.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.09 / $35.65 / $71.15
| Facility | | $14.09 | $35.65 | $71.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Professional | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.24 / $14.24 / $80.00
| Facility | | $14.24 | $14.24 | $80.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.50 / $14.31 / $14.31
| Facility | | $13.50 | $14.31 | $14.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $14.31 / $14.31
| Professional | | $14.31 | $14.31 | $14.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.00 / $85.00 / $85.00
| Facility | | $75.00 | $85.00 | $85.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.68 / $61.68 / $61.68
| Professional | | $61.68 | $61.68 | $61.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.08 / $14.31 / $29.48
| Facility | | $14.08 | $14.31 | $29.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $14.60 / $23.61
| Professional | | $14.31 | $14.60 | $23.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.24 / $16.07 / $28.80
| Professional | | $14.24 | $16.07 | $28.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.31 / $14.31 / $25.55
| Facility | | $14.31 | $14.31 | $25.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $14.31 / $17.14
| Professional | | $14.31 | $14.31 | $17.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.31 / $15.17 / $15.93
| Professional | | $14.31 | $15.17 | $15.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.97 / $14.31 / $20.03
| Professional | | $13.97 | $14.31 | $20.03 |