- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.59 / $36.29 / $56.98
| Professional | | $23.59 | $36.29 | $56.98 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $85.57 / $85.57 / $85.57
| Professional | 25 | $85.57 | $85.57 | $85.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.26 / $68.70 / $77.43
| Professional | | $43.26 | $68.70 | $77.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.79 / $45.79 / $45.79
| Professional | | $45.79 | $45.79 | $45.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.77 / $47.84 / $71.23
| Professional | | $32.77 | $47.84 | $71.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.76 / $39.02 / $65.61
| Facility | | $24.76 | $39.02 | $65.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.37 / $72.92 / $112.48
| Professional | | $53.37 | $72.92 | $112.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.36 / $50.24 / $89.20
| Professional | | $39.36 | $50.24 | $89.20 |