- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.68 / $20.71 / $55.50
| Facility | | $14.68 | $20.71 | $55.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $23.75 / $87.61
| Professional | | $13.49 | $23.75 | $87.61 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $20.07 / $22.78 / $87.00
| Professional | 25 | $20.07 | $22.78 | $87.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.58 / $13.62 / $17.71
| Professional | | $11.58 | $13.62 | $17.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.00 / $91.34 / $150.47
| Facility | | $23.00 | $91.34 | $150.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.67 / $14.36 / $15.64
| Professional | | $11.67 | $14.36 | $15.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.34 / $23.47 / $37.82
| Professional | | $14.34 | $23.47 | $37.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.35 / $19.09 / $37.54
| Facility | | $13.35 | $19.09 | $37.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.85 / $22.04 / $358.00
| Professional | | $14.85 | $22.04 | $358.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.40 / $18.55 / $34.47
| Professional | | $14.40 | $18.55 | $34.47 |