- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.78 / $22.65 / $107.22
| Facility | | $16.78 | $22.65 | $107.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.62 / $13.00 / $16.78
| Professional | | $12.62 | $13.00 | $16.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.30 / $10.13 / $10.13
| Professional | | $7.30 | $10.13 | $10.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.17 / $19.62 / $26.40
| Facility | | $16.17 | $19.62 | $26.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.89 / $10.41 / $14.53
| Professional | | $9.89 | $10.41 | $14.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.40 / $15.35 / $46.21
| Facility | | $11.40 | $15.35 | $46.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.68 / $11.21 / $21.17
| Professional | | $7.68 | $11.21 | $21.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.13 / $8.75 / $20.38
| Professional | | $6.13 | $8.75 | $20.38 |