- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.45 / $16.67 / $20.69
| Professional | | $16.45 | $16.67 | $20.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.64 / $21.64 / $27.94
| Professional | | $21.64 | $21.64 | $27.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.78 / $25.21 / $81.14
| Professional | | $11.78 | $25.21 | $81.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.23 / $26.68 / $33.35
| Professional | | $22.23 | $26.68 | $33.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.34 / $20.32 / $38.81
| Professional | | $13.34 | $20.32 | $38.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.12 / $11.12 / $21.81
| Professional | | $11.12 | $11.12 | $21.81 |