- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.96 / $33.53 / $67.06
| Facility | | $20.96 | $33.53 | $67.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.35 / $25.07 / $25.44
| Professional | | $22.35 | $25.07 | $25.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.76 / $16.76 / $16.76
| Professional | | $16.76 | $16.76 | $16.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.74 / $52.03 / $75.36
| Facility | | $38.74 | $52.03 | $75.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.54 / $26.54 / $27.94
| Professional | | $26.54 | $26.54 | $27.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.86 / $18.16 / $36.15
| Facility | | $14.86 | $18.16 | $36.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.39 / $25.44 / $39.75
| Professional | | $12.39 | $25.44 | $39.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.96 / $25.33 / $132.72
| Facility | | $20.96 | $25.33 | $132.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $11.73 / $27.94
| Professional | | $11.73 | $11.73 | $27.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.73 / $11.73 / $16.76
| Professional | | $11.73 | $11.73 | $16.76 |