- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $69.18 / $134.90
| Professional | | $38.02 | $69.18 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $75.86 / $85.11 / $181.97
| Professional | 25 | $75.86 | $85.11 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $79.43 / $141.25
| Professional | | $45.71 | $79.43 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $69.18 / $125.89
| Professional | | $42.66 | $69.18 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $123.03 / $181.97
| Professional | | $53.70 | $123.03 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $83.18 / $89.13
| Professional | | $44.67 | $83.18 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $70.79 / $123.03
| Professional | | $43.65 | $70.79 | $123.03 |