- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.17 / $53.96 / $84.72
| Professional | | $35.17 | $53.96 | $84.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.01 / $58.84 / $90.14
| Professional | | $50.01 | $58.84 | $90.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.21 / $58.45 / $107.67
| Professional | | $37.21 | $58.45 | $107.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.36 / $67.98 / $406.08
| Professional | | $52.36 | $67.98 | $406.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.81 / $59.93 / $108.25
| Professional | | $51.81 | $59.93 | $108.25 |