- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.60 / $42.13 / $101.70
| Facility | | $14.60 | $42.13 | $101.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.64 / $13.82 / $20.14
| Professional | | $12.64 | $13.82 | $20.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.85 / $22.75 / $27.80
| Facility | | $16.85 | $22.75 | $27.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.85 / $21.06 / $22.75
| Professional | | $16.85 | $21.06 | $22.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.69 / $35.78 / $50.53
| Facility | | $13.69 | $35.78 | $50.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.58 / $24.26 / $106.51
| Professional | | $9.58 | $24.26 | $106.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.35 / $69.20 / $148.13
| Facility | | $13.35 | $69.20 | $148.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.28 / $19.28 / $28.44
| Professional | | $19.28 | $19.28 | $28.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.58 / $10.33 / $34.13
| Professional | | $7.58 | $10.33 | $34.13 |