- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.57 / $83.18 / $173.78
| Professional | | $64.57 | $83.18 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.23 / $63.10 / $114.82
| Professional | | $56.23 | $63.10 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Professional | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.66 / $85.11 / $114.82
| Professional | | $61.66 | $85.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.88 / $74.13 / $104.71
| Professional | | $58.88 | $74.13 | $104.71 |