- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.75 / $25.89 / $29.27
| Professional | | $20.75 | $25.89 | $29.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.13 / $23.13 / $32.61
| Professional | | $23.13 | $23.13 | $32.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.06 / $33.06 / $33.06
| Professional | | $33.06 | $33.06 | $33.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.41 / $27.39 / $37.35
| Professional | | $22.41 | $27.39 | $37.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.64 / $28.26 / $45.20
| Professional | | $20.64 | $28.26 | $45.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Professional | | $30.00 | $30.00 | $30.00 |