- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.08 / $77.48 / $265.86
| Facility | | $13.08 | $77.48 | $265.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.93 / $13.08 / $13.08
| Professional | | $10.93 | $13.08 | $13.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.66 / $27.84 / $65.00
| Facility | | $23.66 | $27.84 | $65.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.75 / $9.34 / $11.04
| Professional | | $5.75 | $9.34 | $11.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.82 / $72.34 / $97.68
| Facility | | $32.82 | $72.34 | $97.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.37 / $10.40 / $20.65
| Professional | | $7.37 | $10.40 | $20.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.52 / $25.56 / $58.22
| Professional | | $19.52 | $25.56 | $58.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.04 / $8.63 / $9.61
| Professional | | $6.04 | $8.63 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $15.32 / $23.14
| Professional | | $13.12 | $15.32 | $23.14 |