- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.02 / $36.86 / $51.22
| Professional | | $30.02 | $36.86 | $51.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.96 / $44.57 / $75.03
| Professional | | $36.96 | $44.57 | $75.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.82 / $50.07 / $109.62
| Professional | | $17.82 | $50.07 | $109.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.68 / $49.05 / $123.71
| Professional | | $31.68 | $49.05 | $123.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.97 / $37.21 / $72.56
| Professional | | $16.97 | $37.21 | $72.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.65 / $31.52 / $40.11
| Professional | | $28.65 | $31.52 | $40.11 |