- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.70 / $41.56 / $81.54
| Facility | | $22.70 | $41.56 | $81.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $12.32 / $14.18
| Professional | | $11.63 | $12.32 | $14.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.70 / $17.44 / $28.13
| Facility | | $16.70 | $17.44 | $28.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.64 / $10.64 / $26.39
| Professional | | $10.64 | $10.64 | $26.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.01 / $33.11 / $58.21
| Facility | | $13.01 | $33.11 | $58.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.02 / $15.33 / $20.65
| Professional | | $10.02 | $15.33 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.96 / $8.06 / $22.69
| Professional | | $5.96 | $8.06 | $22.69 |