- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.71 / $49.04 / $52.24
| Professional | | $31.71 | $49.04 | $52.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.22 / $47.35 / $64.64
| Professional | | $26.22 | $47.35 | $64.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $55.19
| Professional | | $32.34 | $32.34 | $55.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.06 / $47.35 / $62.78
| Professional | | $27.06 | $47.35 | $62.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.51 / $47.47 / $63.59
| Professional | | $32.51 | $47.47 | $63.59 |