- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.80 / $43.04 / $52.02
| Professional | | $31.80 | $43.04 | $52.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.53 / $101.30 / $138.43
| Professional | | $61.53 | $101.30 | $138.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.02 / $89.53 / $153.62
| Professional | | $35.02 | $89.53 | $153.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.17 / $86.70 / $134.63
| Professional | | $42.17 | $86.70 | $134.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.51 / $47.81 / $120.24
| Professional | | $32.51 | $47.81 | $120.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.28 / $47.81 / $100.60
| Professional | | $33.28 | $47.81 | $100.60 |