- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $21.51 / $25.82
| Facility | | $14.11 | $21.51 | $25.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.91 / $14.11 / $14.63
| Professional | | $12.91 | $14.11 | $14.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.23 / $96.81 / $464.68
| Facility | | $23.23 | $96.81 | $464.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.65 / $23.23 / $119,998.80
| Professional | | $20.65 | $23.23 | $119,998.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.99 / $20.65 / $51.64
| Facility | | $13.99 | $20.65 | $51.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.95 / $82.95 / $82.95
| Professional | | $82.95 | $82.95 | $82.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.23 / $8.61 / $27.54
| Professional | | $7.23 | $8.61 | $27.54 |