- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.27 / $40.15 / $54.09
| Professional | | $35.27 | $40.15 | $54.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.81 / $60.00 / $157.47
| Professional | | $31.81 | $60.00 | $157.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.68 / $64.48 / $71.77
| Professional | | $59.68 | $64.48 | $71.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.25 / $40.83 / $80.76
| Professional | | $32.25 | $40.83 | $80.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.28 / $46.64 / $117.53
| Professional | | $35.28 | $46.64 | $117.53 |