- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $33.88 / $41.69
| Professional | | $28.18 | $33.88 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $37.15 / $39.81
| Professional | | $12.02 | $37.15 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $33.88 / $56.23
| Professional | | $13.49 | $33.88 | $56.23 |
- 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
- $17.78 / $27.54 / $38.02
| Professional | | $17.78 | $27.54 | $38.02 |