- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.68 / $59.12 / $107.69
| Professional | | $18.68 | $59.12 | $107.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.62 / $18.62 / $54.13
| Professional | | $18.62 | $18.62 | $54.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $55.39 / $112.44
| Professional | | $16.73 | $55.39 | $112.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.20 / $92.36 / $137.58
| Professional | | $72.20 | $92.36 | $137.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.87 / $65.02 / $107.26
| Professional | | $43.87 | $65.02 | $107.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.93 / $22.33 / $91.72
| Professional | | $21.93 | $22.33 | $91.72 |