- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $34.86 / $66.87
| Facility | | $19.05 | $34.86 | $66.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.16 / $10.55 / $12.12
| Professional | | $6.16 | $10.55 | $12.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.70 / $14.30 / $23.60
| Facility | | $13.70 | $14.30 | $23.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.10 / $8.72 / $22.14
| Professional | | $6.10 | $8.72 | $22.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.01 / $27.76 / $48.80
| Facility | | $11.01 | $27.76 | $48.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.41 / $12.86 / $16.52
| Professional | | $8.41 | $12.86 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.88 / $13.65 / $18.61
| Professional | | $4.88 | $13.65 | $18.61 |