- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.43 / $26.91 / $46.46
| Facility | | $15.43 | $26.91 | $46.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.61 / $11.12 / $13.00
| Professional | | $10.61 | $11.12 | $13.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.55 / $13.21 / $96.00
| Professional | | $12.55 | $13.21 | $96.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.26 / $81.30 / $116.06
| Professional | | $14.26 | $81.30 | $116.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.95 / $15.87 / $15.87
| Professional | | $14.95 | $15.87 | $15.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.80 / $15.68 / $33.47
| Professional | | $11.80 | $15.68 | $33.47 |