- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.55 / $19.52 / $44.32
| Facility | | $10.55 | $19.52 | $44.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.36 / $10.97 / $12.52
| Professional | | $9.36 | $10.97 | $12.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.26 / $8.18 / $14.07
| Professional | | $4.26 | $8.18 | $14.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.30 / $24.12 / $44.02
| Facility | | $5.30 | $24.12 | $44.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.70 / $6.41 / $20.13
| Professional | | $3.70 | $6.41 | $20.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.47 / $70.00 / $100.00
| Facility | | $34.47 | $70.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.12 / $5.91 / $14.07
| Professional | | $4.12 | $5.91 | $14.07 |