- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.48 / $75.86 / $144.54
| Professional | | $52.48 | $75.86 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.13 / $77.62 / $97.72
| Professional | | $74.13 | $77.62 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $46.77 / $79.43
| Professional | | $30.20 | $46.77 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $104.71 / $125.89
| Professional | | $75.86 | $104.71 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $75.86 / $416.87
| Professional | | $31.62 | $75.86 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $32.36 / $33.11
| Professional | | $10.96 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.30 / $57.54 / $117.49
| Professional | | $26.30 | $57.54 | $117.49 |