- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.87 / $30.84 / $57.51
| Professional | | $16.87 | $30.84 | $57.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.79 / $30.36 / $48.47
| Professional | | $17.79 | $30.36 | $48.47 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $26.68 / $45.54 / $72.70
| Professional | 50 | $26.68 | $45.54 | $72.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.82 / $50.43 / $97.71
| Professional | | $25.82 | $50.43 | $97.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.24 / $42.96 / $94.71
| Professional | | $22.24 | $42.96 | $94.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.13 / $66.77 / $105.23
| Professional | | $40.13 | $66.77 | $105.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.38 / $31.45 / $47.76
| Professional | | $16.38 | $31.45 | $47.76 |