- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.04 / $32.59 / $39.06
| Professional | | $28.04 | $32.59 | $39.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.67 / $65.70 / $104.13
| Professional | | $27.67 | $65.70 | $104.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $18.96 / $34.42
| Professional | | $12.10 | $18.96 | $34.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.37 / $60.88 / $109.51
| Professional | | $31.37 | $60.88 | $109.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.46 / $34.78 / $71.27
| Professional | | $25.46 | $34.78 | $71.27 |