- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.66 / $36.22 / $39.15
| Professional | | $26.66 | $36.22 | $39.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.93 / $61.21 / $100.09
| Professional | | $33.93 | $61.21 | $100.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.22 / $41.36 / $64.81
| Professional | | $29.22 | $41.36 | $64.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.45 / $32.84 / $44.29
| Professional | | $25.45 | $32.84 | $44.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.78 / $33.27 / $48.65
| Professional | | $26.78 | $33.27 | $48.65 |