- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.63 / $13.86 / $84.27
| Facility | | $10.63 | $13.86 | $84.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $13.86 / $15.46
| Professional | | $13.86 | $13.86 | $15.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.73 / $35.20 / $60.32
| Facility | | $12.73 | $35.20 | $60.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.00 / $9.68 / $20.29
| Professional | | $8.00 | $9.68 | $20.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.29 / $51.51 / $106.67
| Facility | | $32.29 | $51.51 | $106.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.05 / $9.52 / $25.81
| Professional | | $8.05 | $9.52 | $25.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6.50 / $14.50 / $28.26
| Facility | | $6.50 | $14.50 | $28.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.66 / $17.00 / $21.59
| Professional | | $6.66 | $17.00 | $21.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.77 / $9.77 / $14.07
| Professional | | $9.77 | $9.77 | $14.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3.58 / $9.65 / $17.77
| Professional | | $3.58 | $9.65 | $17.77 |