- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.02 / $46.58 / $277.45
| Professional | | $28.02 | $46.58 | $277.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.77 / $27.40 / $35.24
| Professional | | $21.77 | $27.40 | $35.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.83 / $50.00 / $87.92
| Professional | | $23.83 | $50.00 | $87.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.57 / $39.45 / $64.81
| Professional | | $29.57 | $39.45 | $64.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.46 / $41.17 / $74.31
| Professional | | $31.46 | $41.17 | $74.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.41 / $36.91 / $57.46
| Professional | | $27.41 | $36.91 | $57.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.54 / $32.21 / $49.29
| Professional | | $24.54 | $32.21 | $49.29 |