- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.85 / $55.46 / $144.25
| Facility | | $16.85 | $55.46 | $144.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.06 / $15.02 / $16.85
| Professional | | $12.06 | $15.02 | $16.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.85 / $21.53 / $58.30
| Facility | | $16.85 | $21.53 | $58.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.14 / $8.32 / $17.53
| Professional | | $8.14 | $8.32 | $17.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.78 / $28.20 / $56.39
| Facility | | $11.78 | $28.20 | $56.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.80 / $19.41 / $24.65
| Professional | | $10.80 | $19.41 | $24.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.23 / $23.23 / $23.23
| Facility | | $23.23 | $23.23 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.11 / $23.54
| Professional | | $7.08 | $10.11 | $23.54 |