- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29.56 / $54.12 / $127.48
| Facility | | $29.56 | $54.12 | $127.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.03 / $32.50 / $46.56
| Professional | | $16.03 | $32.50 | $46.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.58 / $26.11 / $36.63
| Facility | | $24.58 | $26.11 | $36.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.63 / $16.63 / $34.38
| Professional | | $16.63 | $16.63 | $34.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17.01 / $43.10 / $75.77
| Facility | | $17.01 | $43.10 | $75.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.06 / $19.97 / $32.01
| Professional | | $13.06 | $19.97 | $32.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.76 / $13.19 / $35.72
| Professional | | $7.76 | $13.19 | $35.72 |