- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.28 / $59.70 / $76.18
| Professional | | $46.28 | $59.70 | $76.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.48 / $58.40 / $61.47
| Professional | | $55.48 | $58.40 | $61.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.54 / $122.83 / $300.08
| Professional | | $53.54 | $122.83 | $300.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.40 / $55.87 / $146.88
| Professional | | $45.40 | $55.87 | $146.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.07 / $68.52 / $135.94
| Professional | | $50.07 | $68.52 | $135.94 |