- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.98 / $22.37 / $35.79
| Professional | | $17.98 | $22.37 | $35.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76.59 / $103.48 / $122.51
| Facility | | $76.59 | $103.48 | $122.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.21 / $28.48 / $47.63
| Professional | | $24.21 | $28.48 | $47.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23.00 / $34.71 / $38.29
| Facility | | $23.00 | $34.71 | $38.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.54 / $34.71 / $38.29
| Professional | | $32.54 | $34.71 | $38.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.83 / $31.03 / $45.05
| Professional | | $20.83 | $31.03 | $45.05 |