- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.56 / $53.34 / $72.70
| Professional | | $37.56 | $53.34 | $72.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.56 / $66.27 / $108.72
| Professional | | $51.56 | $66.27 | $108.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.79 / $63.68 / $158.91
| Professional | | $39.79 | $63.68 | $158.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.39 / $73.37 / $185.02
| Professional | | $47.39 | $73.37 | $185.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.86 / $51.12 / $131.90
| Professional | | $37.86 | $51.12 | $131.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.51 / $45.28 / $71.80
| Professional | | $32.51 | $45.28 | $71.80 |