- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.76 / $33.33 / $34.72
| Professional | | $30.76 | $33.33 | $34.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.90 / $32.56 / $106.80
| Facility | | $10.90 | $32.56 | $106.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.47 / $23.06 / $37.40
| Professional | | $18.47 | $23.06 | $37.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.49 / $63.33 / $75.62
| Facility | | $52.49 | $63.33 | $75.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.77 / $35.86 / $67.68
| Professional | | $23.77 | $35.86 | $67.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $22.05 / $38.39
| Professional | | $17.48 | $22.05 | $38.39 |