- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.61 / $25.88 / $37.47
| Professional | | $20.61 | $25.88 | $37.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.62 / $23.62 / $26.69
| Professional | | $23.62 | $23.62 | $26.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.81 / $23.81 / $23.81
| Professional | | $23.81 | $23.81 | $23.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.12 / $32.38 / $41.96
| Professional | | $22.12 | $32.38 | $41.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.91 / $25.88 / $49.70
| Professional | | $12.91 | $25.88 | $49.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.38 / $32.17 / $40.09
| Professional | | $22.38 | $32.17 | $40.09 |