- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.69 / $11.02 / $14.50
| Professional | | $10.69 | $11.02 | $14.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.58 / $46.72 / $55.31
| Facility | | $34.58 | $46.72 | $55.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.92 / $12.85 / $21.50
| Professional | | $10.92 | $12.85 | $21.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.18 / $12.18 / $14.15
| Facility | | $12.18 | $12.18 | $14.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.89 / $12.18 / $12.18
| Professional | | $8.89 | $12.18 | $12.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.31 / $12.20 / $20.34
| Professional | | $8.31 | $12.20 | $20.34 |