- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.13 / $28.24 / $39.31
| Professional | | $21.13 | $28.24 | $39.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.00 / $35.22 / $42.60
| Professional | | $35.00 | $35.22 | $42.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.71 / $33.47 / $52.77
| Professional | | $18.71 | $33.47 | $52.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.57 / $37.76 / $67.63
| Professional | | $21.57 | $37.76 | $67.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $39.45 / $46.69
| Professional | | $32.34 | $39.45 | $46.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.46 / $25.71 / $44.46
| Professional | | $18.46 | $25.71 | $44.46 |