- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $20.75 / $32.96
| Professional | | $15.66 | $20.75 | $32.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.96 / $26.10 / $41.39
| Professional | | $16.96 | $26.10 | $41.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.60 / $33.08 / $58.71
| Professional | | $20.60 | $33.08 | $58.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.55 / $31.13 / $55.61
| Professional | | $18.55 | $31.13 | $55.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $20.75 / $32.96
| Professional | | $15.66 | $20.75 | $32.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.01 / $36.26 / $56.74
| Professional | | $29.01 | $36.26 | $56.74 |