- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.51 / $21.42 / $28.36
| Professional | | $17.51 | $21.42 | $28.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.23 / $27.29 / $56.76
| Professional | | $16.23 | $27.29 | $56.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.43 / $31.41 / $41.07
| Professional | | $24.43 | $31.41 | $41.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.02 / $28.65 / $41.66
| Professional | | $20.02 | $28.65 | $41.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.77 / $24.03 / $41.49
| Professional | | $15.77 | $24.03 | $41.49 |