- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.73 / $32.86 / $105.30
| Professional | | $27.73 | $32.86 | $105.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.75 / $32.75 / $56.66
| Professional | | $32.75 | $32.75 | $56.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.39 / $42.36 / $88.46
| Professional | | $28.39 | $42.36 | $88.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.26 / $33.94 / $50.17
| Professional | | $26.26 | $33.94 | $50.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.56 / $35.59 / $59.92
| Professional | | $26.56 | $35.59 | $59.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.70 / $27.70 / $42.69
| Professional | | $27.70 | $27.70 | $42.69 |