- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.25 / $55.56 / $62.84
| Professional | | $44.25 | $55.56 | $62.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.79 / $50.91 / $124.31
| Professional | | $38.79 | $50.91 | $124.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.44 / $72.43 / $93.83
| Professional | | $54.44 | $72.43 | $93.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $83.37
| Professional | | $32.34 | $32.34 | $83.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.81 / $80.48 / $145.56
| Professional | | $56.81 | $80.48 | $145.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.02 / $75.06 / $111.19
| Professional | | $57.02 | $75.06 | $111.19 |