- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.05 / $40.74 / $104.71
| Facility | | $19.05 | $40.74 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $20.89 / $32.36
| Professional | | $7.08 | $20.89 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.88 / $34.67 / $114.82
| Facility | | $21.88 | $34.67 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.08 / $10.72 / $32.36
| Professional | | $7.08 | $10.72 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $43.65 / $104.71
| Facility | | $10.96 | $43.65 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.03 / $31.62 / $66.07
| Professional | | $6.03 | $31.62 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.08 / $26.92 / $32.36
| Facility | | $7.08 | $26.92 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.01 / $11.48 / $26.92
| Professional | | $5.01 | $11.48 | $26.92 |