- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.72 / $44.00 / $46.08
| Professional | | $36.72 | $44.00 | $46.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.84 / $206.33 / $206.33
| Professional | | $51.84 | $206.33 | $206.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $45.00 / $216.58
| Professional | | $30.00 | $45.00 | $216.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.99 / $49.48 / $59.97
| Professional | | $39.99 | $49.48 | $59.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.96 / $41.84 / $62.97
| Professional | | $33.96 | $41.84 | $62.97 |