- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.58 / $31.58 / $36.74
| Professional | | $24.58 | $31.58 | $36.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.75 / $16.00 / $24.40
| Professional | | $12.75 | $16.00 | $24.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.77 / $38.11 / $44.30
| Professional | | $31.77 | $38.11 | $44.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.54 / $26.82 / $46.45
| Professional | | $15.54 | $26.82 | $46.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.98 / $27.00 / $41.90
| Professional | | $18.98 | $27.00 | $41.90 |