- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $33.88 / $46.77
| Professional | | $28.18 | $33.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $44.67 / $77.62
| Professional | | $43.65 | $44.67 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $42.66 / $70.79
| Professional | | $17.78 | $42.66 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.05 / $48.98 / $102.33
| Professional | | $19.05 | $48.98 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $32.36 / $56.23
| Professional | | $22.39 | $32.36 | $56.23 |