- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.17 / $116.39 / $152.31
| Facility | | $22.17 | $116.39 | $152.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $15.34 / $22.17
| Professional | | $13.06 | $15.34 | $22.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.42 / $15.86 / $49.72
| Facility | | $15.42 | $15.86 | $49.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.75 / $20.65 / $25.81
| Professional | | $10.75 | $20.65 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.05 / $20.76 / $81.23
| Facility | | $18.05 | $20.76 | $81.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.82 / $14.65 / $20.75
| Professional | | $13.82 | $14.65 | $20.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $10.33 / $10.83
| Professional | | $7.58 | $10.33 | $10.83 |