- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.92 / $67.65 / $204.04
| Professional | | $50.92 | $67.65 | $204.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.61 / $72.18 / $115.60
| Professional | | $50.61 | $72.18 | $115.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.68 / $73.81 / $89.28
| Professional | | $52.68 | $73.81 | $89.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $72.15
| Professional | | $32.34 | $32.34 | $72.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.36 / $68.66 / $97.59
| Professional | | $58.36 | $68.66 | $97.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.78 / $72.67 / $100.35
| Professional | | $49.78 | $72.67 | $100.35 |