- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.66 / $92.48 / $136.30
| Facility | | $12.66 | $92.48 | $136.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.01 / $10.55 / $15.34
| Professional | | $9.01 | $10.55 | $15.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.40 / $11.73 / $36.75
| Facility | | $11.40 | $11.73 | $36.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.23 / $15.28 / $19.10
| Professional | | $6.23 | $15.28 | $19.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.34 / $15.34 / $54.03
| Facility | | $13.34 | $15.34 | $54.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.22 / $10.85 / $15.56
| Professional | | $10.22 | $10.85 | $15.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.60 / $5.91 / $13.96
| Professional | | $5.60 | $5.91 | $13.96 |