- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.00 / $71.04 / $214.94
| Facility | | $33.00 | $71.04 | $214.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.33 / $13.86 / $26.40
| Professional | | $10.33 | $13.86 | $26.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.84 / $14.96 / $22.27
| Facility | | $14.84 | $14.96 | $22.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.44 / $9.44 / $20.58
| Professional | | $9.44 | $9.44 | $20.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.44 / $35.18 / $61.84
| Facility | | $33.44 | $35.18 | $61.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.13 / $14.46 / $30.87
| Professional | | $7.13 | $14.46 | $30.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.41 / $8.98 / $21.58
| Professional | | $4.41 | $8.98 | $21.58 |