- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.71 / $66.07 / $83.18
| Professional | | $45.71 | $66.07 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $35.48 / $72.44
| Professional | | $14.13 | $35.48 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $64.57 / $102.33
| Professional | | $15.14 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $52.48 / $74.13
| Professional | | $19.05 | $52.48 | $74.13 |