- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.39 / $44.01 / $67.08
| Professional | | $33.39 | $44.01 | $67.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.27 / $63.55 / $80.73
| Professional | | $43.27 | $63.55 | $80.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.43 / $44.42 / $124.38
| Professional | | $24.43 | $44.42 | $124.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.56 / $22.56 / $58.70
| Professional | | $22.56 | $22.56 | $58.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.59 / $50.20 / $117.72
| Professional | | $28.59 | $50.20 | $117.72 |