- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.59 / $57.63 / $96.51
| Facility | | $34.59 | $57.63 | $96.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.67 / $10.13 / $20.26
| Professional | | $9.67 | $10.13 | $20.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.53 / $13.58 / $14.76
| Facility | | $11.53 | $13.58 | $14.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.65 / $8.65 / $14.09
| Professional | | $8.65 | $8.65 | $14.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.46 / $13.22 / $16.52
| Professional | | $6.46 | $13.22 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.04 / $6.92 / $16.63
| Professional | | $4.04 | $6.92 | $16.63 |