- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.69 / $12.31 / $14.54
| Facility | | $9.69 | $12.31 | $14.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.65 / $13.05 / $20.00
| Professional | | $10.65 | $13.05 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.46 / $12.89 / $16.89
| Professional | | $11.46 | $12.89 | $16.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.34 / $10.34 / $49.87
| Facility | | $10.34 | $10.34 | $49.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.43 / $11.94 / $13.68
| Professional | | $9.43 | $11.94 | $13.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $16.98
| Facility | | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.85 / $17.79 / $32.70
| Professional | | $12.85 | $17.79 | $32.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.65 / $13.87 / $24.49
| Facility | | $10.65 | $13.87 | $24.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.33 / $17.63 / $93.56
| Professional | | $13.33 | $17.63 | $93.56 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $16.25 / $16.25 / $16.25
| Professional | 25 | $16.25 | $16.25 | $16.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.19 / $15.52 / $33.06
| Professional | | $13.19 | $15.52 | $33.06 |