- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.15 / $47.70 / $55.16
| Professional | | $45.15 | $47.70 | $55.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.68 / $79.30 / $125.69
| Professional | | $28.68 | $79.30 | $125.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.32 / $51.19 / $63.45
| Professional | | $45.32 | $51.19 | $63.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.85 / $45.60 / $102.07
| Professional | | $23.85 | $45.60 | $102.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.19 / $49.83 / $82.26
| Professional | | $31.19 | $49.83 | $82.26 |