- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.33 / $24.84 / $43.46
| Professional | | $24.33 | $24.84 | $43.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.82 / $76.56 / $100.52
| Professional | | $48.82 | $76.56 | $100.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $38.22 / $100.42
| Professional | | $15.71 | $38.22 | $100.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.33 / $40.57 / $79.84
| Facility | | $24.33 | $40.57 | $79.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.39 / $62.25 / $247.97
| Professional | | $36.39 | $62.25 | $247.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.04 / $49.51 / $80.86
| Professional | | $33.04 | $49.51 | $80.86 |