- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.71 / $25.00 / $134.00
| Professional | | $19.71 | $25.00 | $134.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.00 / $22.30 / $31.26
| Professional | | $17.00 | $22.30 | $31.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.40 / $75.52 / $145.05
| Professional | | $34.40 | $75.52 | $145.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $35.72
| Professional | | $32.34 | $32.34 | $35.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.48 / $55.16 / $72.05
| Professional | | $31.48 | $55.16 | $72.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.40 / $37.01 / $52.45
| Professional | | $23.40 | $37.01 | $52.45 |