- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.28 / $41.16 / $73.98
| Professional | | $32.28 | $41.16 | $73.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.72 / $117.52 / $120.01
| Professional | | $39.72 | $117.52 | $120.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.89 / $46.30 / $75.15
| Professional | | $32.89 | $46.30 | $75.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.47 / $48.25 / $78.41
| Professional | | $35.47 | $48.25 | $78.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.73 / $325.73 / $368.48
| Professional | | $325.73 | $325.73 | $368.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.37 / $43.83 / $71.36
| Professional | | $30.37 | $43.83 | $71.36 |