- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.90 / $48.98 / $64.57
| Professional | | $38.90 | $48.98 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $58.88 / $123.03
| Professional | | $36.31 | $58.88 | $123.03 |
- 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
- $40.74 / $52.48 / $102.33
| Professional | | $40.74 | $52.48 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $45.71 / $67.61
| Professional | | $28.84 | $45.71 | $67.61 |