- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $20.07 / $29.67
| Professional | | $15.66 | $20.07 | $29.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.66 / $25.75 / $48.85
| Professional | | $10.66 | $25.75 | $48.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.21 / $15.02 / $63.52
| Professional | | $11.21 | $15.02 | $63.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.98 / $30.25 / $60.23
| Professional | | $18.98 | $30.25 | $60.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.76 / $35.86 / $45.68
| Professional | | $31.76 | $35.86 | $45.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.66 / $27.76 / $59.05
| Professional | | $16.66 | $27.76 | $59.05 |