- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $34.58 / $97.85
| Professional | | $32.15 | $34.58 | $97.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.79 / $40.83 / $43.67
| Professional | | $38.79 | $40.83 | $43.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.60 / $45.94 / $56.85
| Professional | | $27.60 | $45.94 | $56.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.56 / $32.61 / $94.01
| Professional | | $29.56 | $32.61 | $94.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.86 / $33.77 / $41.02
| Professional | | $28.86 | $33.77 | $41.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.45 / $35.47 / $53.37
| Professional | | $32.45 | $35.47 | $53.37 |