- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.57 / $56.03 / $90.36
| Professional | | $49.57 | $56.03 | $90.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.93 / $73.75 / $115.24
| Professional | | $46.93 | $73.75 | $115.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.28 / $82.63 / $162.16
| Professional | | $52.28 | $82.63 | $162.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.82 / $81.47 / $141.10
| Professional | | $47.82 | $81.47 | $141.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.57 / $56.03 / $90.36
| Professional | | $49.57 | $56.03 | $90.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.17 / $102.53 / $149.21
| Professional | | $76.17 | $102.53 | $149.21 |