- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.75 / $76.41 / $144.82
| Professional | | $57.75 | $76.41 | $144.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.58 / $54.38 / $73.42
| Professional | | $50.58 | $54.38 | $73.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.97 / $110.56 / $164.22
| Professional | | $65.97 | $110.56 | $164.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.38 / $65.26 / $81.56
| Professional | | $54.38 | $65.26 | $81.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.16 / $86.94 / $142.61
| Professional | | $60.16 | $86.94 | $142.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.26 / $70.73 / $102.97
| Professional | | $57.26 | $70.73 | $102.97 |