- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.56 / $22.01 / $25.33
| Professional | | $15.56 | $22.01 | $25.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $18.76 / $28.64
| Professional | | $16.73 | $18.76 | $28.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.38 / $54.43 / $114.34
| Professional | | $18.38 | $54.43 | $114.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.48 / $32.22 / $66.30
| Professional | | $21.48 | $32.22 | $66.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.57 / $21.77 / $33.63
| Professional | | $16.57 | $21.77 | $33.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.42 / $22.17 / $31.10
| Professional | | $16.42 | $22.17 | $31.10 |