- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.71 / $28.15 / $38.46
| Professional | | $22.71 | $28.15 | $38.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.26 / $38.03 / $63.01
| Professional | | $21.26 | $38.03 | $63.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.33 / $38.79 / $52.90
| Professional | | $32.33 | $38.79 | $52.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.63 / $29.21 / $51.54
| Professional | | $23.63 | $29.21 | $51.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.75 / $30.76 / $56.91
| Professional | | $22.75 | $30.76 | $56.91 |