- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.31 / $48.16 / $92.40
| Facility | | $26.31 | $48.16 | $92.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.78 / $42.03 / $43.74
| Professional | | $23.78 | $42.03 | $43.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.93 / $19.77 / $32.59
| Facility | | $18.93 | $19.77 | $32.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $12.05 / $30.58
| Professional | | $12.05 | $12.05 | $30.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.01 / $38.36 / $67.44
| Facility | | $15.01 | $38.36 | $67.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $15.20 / $23.23
| Professional | | $11.63 | $15.20 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.75 / $11.22 / $25.71
| Professional | | $6.75 | $11.22 | $25.71 |