- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.14 / $47.42 / $92.67
| Professional | | $30.14 | $47.42 | $92.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.26 / $53.13 / $74.90
| Professional | | $41.26 | $53.13 | $74.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.50 / $52.62 / $93.85
| Professional | | $32.50 | $52.62 | $93.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.50 / $57.76 / $406.08
| Professional | | $43.50 | $57.76 | $406.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.12 / $51.10 / $97.74
| Professional | | $42.12 | $51.10 | $97.74 |