- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.53 / $73.78 / $92.48
| Professional | | $55.53 | $73.78 | $92.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.38 / $124.42 / $157.16
| Professional | | $29.38 | $124.42 | $157.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.91 / $94.06 / $307.33
| Professional | | $56.91 | $94.06 | $307.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.03 / $75.48 / $110.40
| Professional | | $62.03 | $75.48 | $110.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.62 / $66.18 / $94.72
| Professional | | $52.62 | $66.18 | $94.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.98 / $71.23 / $113.77
| Professional | | $49.98 | $71.23 | $113.77 |