- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $30.36 / $83.50
| Facility | | $8.02 | $30.36 | $83.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.30 / $11.23 / $57.55
| Professional | | $10.30 | $11.23 | $57.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.02 / $11.59 / $13.54
| Facility | | $8.02 | $11.59 | $13.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.09 / $6.36 / $12.76
| Professional | | $6.09 | $6.36 | $12.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $18.03 / $21.25
| Facility | | $12.88 | $18.03 | $21.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.78 / $16.73 / $25.76
| Professional | | $13.78 | $16.73 | $25.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.36 / $10.02 / $27.37
| Facility | | $8.36 | $10.02 | $27.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.60 / $14.87 / $82.64
| Professional | | $6.60 | $14.87 | $82.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.25 / $10.52 / $18.00
| Professional | | $5.25 | $10.52 | $18.00 |