- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.86 / $37.72 / $45.36
| Professional | | $36.86 | $37.72 | $45.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.68 / $47.49 / $73.52
| Professional | | $34.68 | $47.49 | $73.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.06 / $52.53 / $93.30
| Professional | | $39.06 | $52.53 | $93.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.62 / $62.52 / $119.54
| Professional | | $30.62 | $62.52 | $119.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.51 / $53.74 / $100.97
| Professional | | $28.51 | $53.74 | $100.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.81 / $42.22 / $59.99
| Professional | | $31.81 | $42.22 | $59.99 |