- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.34 / $22.27 / $26.51
| Professional | | $14.34 | $22.27 | $26.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.02 / $29.02 / $49.74
| Professional | | $15.02 | $29.02 | $49.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.78 / $51.05 / $78.44
| Professional | | $33.78 | $51.05 | $78.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.76 / $54.32 / $113.52
| Professional | | $32.76 | $54.32 | $113.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.76 / $49.01 / $78.44
| Professional | | $32.76 | $49.01 | $78.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.03 / $54.32 / $68.98
| Professional | | $32.03 | $54.32 | $68.98 |