- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.66 / $18.63 / $41.38
| Professional | | $13.66 | $18.63 | $41.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.48 / $22.48 / $36.29
| Professional | | $5.48 | $22.48 | $36.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.44 / $16.98 / $53.83
| Professional | | $12.44 | $16.98 | $53.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.95 / $20.75 / $30.27
| Professional | | $16.95 | $20.75 | $30.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.34 / $9.16 / $11.50
| Professional | | $2.34 | $9.16 | $11.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.44 / $22.55 / $51.59
| Professional | | $15.44 | $22.55 | $51.59 |