- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $33.88 / $81.28
| Professional | | $28.18 | $33.88 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $32.36 / $36.31
| Professional | | $28.84 | $32.36 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $25.70 / $72.44
| Professional | | $19.95 | $25.70 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.74 / $48.98 / $61.66
| Professional | | $40.74 | $48.98 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.98 / $16.98 / $30.90
| Facility | | $16.98 | $16.98 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.44 / $28.18 / $57.54
| Professional | | $23.44 | $28.18 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.42 / $32.36 / $32.36
| Professional | | $20.42 | $32.36 | $32.36 |