- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.71 / $4.84 / $10.53
| Professional | | $1.71 | $4.84 | $10.53 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $0.86 / $2.43 / $2.43
| Professional | 52 | $0.86 | $2.43 | $2.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.41 / $5.11 / $10.16
| Professional | | $2.41 | $5.11 | $10.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.33 / $5.40 / $13.07
| Professional | | $2.33 | $5.40 | $13.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.82 / $9.71 / $13.56
| Professional | | $5.82 | $9.71 | $13.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.47 / $7.00 / $13.87
| Professional | | $2.47 | $7.00 | $13.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1.70 / $4.84 / $10.53
| Professional | | $1.70 | $4.84 | $10.53 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $0.86 / $2.43 / $4.38
| Professional | 52 | $0.86 | $2.43 | $4.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.84 / $7.66 / $13.61
| Professional | | $4.84 | $7.66 | $13.61 |