- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.51 / $60.27 / $79.83
| Professional | | $45.51 | $60.27 | $79.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.58 / $88.93 / $107.70
| Professional | | $55.58 | $88.93 | $107.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.53 / $93.40 / $106.74
| Professional | | $79.53 | $93.40 | $106.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $51.34 / $100.11
| Professional | | $32.34 | $51.34 | $100.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.03 / $84.08 / $106.60
| Professional | | $65.03 | $84.08 | $106.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.56 / $80.37 / $118.33
| Professional | | $61.56 | $80.37 | $118.33 |