- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.53 / $37.45 / $52.02
| Professional | | $31.53 | $37.45 | $52.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.85 / $32.24 / $36.84
| Professional | | $30.85 | $32.24 | $36.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.74 / $43.66 / $76.00
| Professional | | $29.74 | $43.66 | $76.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.69 / $41.33 / $357.52
| Professional | | $30.69 | $41.33 | $357.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.08 / $36.63 / $50.20
| Professional | | $30.08 | $36.63 | $50.20 |