- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25.37 / $46.44 / $92.54
| Facility | | $25.37 | $46.44 | $92.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.71 / $14.04 / $18.55
| Professional | | $12.71 | $14.04 | $18.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.26 / $19.07 / $31.43
| Facility | | $18.26 | $19.07 | $31.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $11.63 / $29.49
| Professional | | $11.63 | $11.63 | $29.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.00 / $45.71 / $65.04
| Facility | | $37.00 | $45.71 | $65.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.27 / $17.76 / $22.20
| Professional | | $11.27 | $17.76 | $22.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $15.50 / $30.66
| Professional | | $5.43 | $15.50 | $30.66 |