- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43.51 / $174.60 / $542.83
| Facility | | $43.51 | $174.60 | $542.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.64 / $27.29 / $43.51
| Professional | | $22.64 | $27.29 | $43.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.06 / $162.06 / $162.06
| Facility | | $162.06 | $162.06 | $162.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.50 / $12.50 / $12.50
| Professional | | $8.50 | $12.50 | $12.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.81 / $22.06 / $49.99
| Facility | | $0.81 | $22.06 | $49.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.94 / $31.80 / $39.75
| Professional | | $10.94 | $31.80 | $39.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.00 / $14.02 / $23.39
| Professional | | $11.00 | $14.02 | $23.39 |