- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.84 / $64.40 / $82.88
| Professional | | $58.84 | $64.40 | $82.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.00 / $62.94 / $100.36
| Professional | | $48.00 | $62.94 | $100.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.52 / $77.00 / $154.38
| Professional | | $50.52 | $77.00 | $154.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.75 / $56.00 / $164.37
| Professional | | $46.75 | $56.00 | $164.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.83 / $74.01 / $114.92
| Professional | | $55.83 | $74.01 | $114.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.50 / $62.47 / $102.27
| Professional | | $47.50 | $62.47 | $102.27 |