- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.06 / $32.54 / $55.64
| Professional | | $21.06 | $32.54 | $55.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.03 / $21.71 / $22.14
| Professional | | $17.03 | $21.71 | $22.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.37 / $26.20 / $42.21
| Professional | | $21.37 | $26.20 | $42.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.03 / $20.44 / $28.10
| Professional | | $17.03 | $20.44 | $28.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.26 / $40.40 / $62.52
| Professional | | $21.26 | $40.40 | $62.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.84 / $32.34 / $32.34
| Professional | | $23.84 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.13 / $32.74 / $50.82
| Professional | | $22.13 | $32.74 | $50.82 |