- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.78 / $80.29 / $124.83
| Professional | | $38.78 | $80.29 | $124.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.96 / $96.89 / $183.05
| Professional | | $52.96 | $96.89 | $183.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.42 / $64.42 / $152.27
| Professional | | $64.42 | $64.42 | $152.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.05 / $86.90 / $193.52
| Professional | | $45.05 | $86.90 | $193.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.70 / $77.65 / $159.46
| Professional | | $65.70 | $77.65 | $159.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.99 / $77.97 / $105.58
| Professional | | $47.99 | $77.97 | $105.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.50 / $117.14 / $242.05
| Professional | | $52.50 | $117.14 | $242.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.06 / $111.43 / $256.43
| Professional | | $64.06 | $111.43 | $256.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.39 / $79.69 / $137.96
| Professional | | $53.39 | $79.69 | $137.96 |