- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.30 / $37.04 / $191.62
| Facility | | $21.30 | $37.04 | $191.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.96 / $16.54 / $21.62
| Professional | | $12.96 | $16.54 | $21.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.26 / $11.11 / $12.86
| Professional | | $9.26 | $11.11 | $12.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.73 / $20.32 / $27.34
| Facility | | $16.73 | $20.32 | $27.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $13.54 / $18.89
| Professional | | $12.86 | $13.54 | $18.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.48 / $19.48 / $58.53
| Facility | | $14.48 | $19.48 | $58.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.25 / $15.08 / $26.33
| Professional | | $10.25 | $15.08 | $26.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.78 / $10.87 / $25.88
| Professional | | $7.78 | $10.87 | $25.88 |