- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $30.90 / $52.48
| Professional | | $16.60 | $30.90 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $23.44 / $37.15
| Professional | | $17.78 | $23.44 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $26.30 / $35.48 / $56.23
| Professional | 50 | $26.30 | $35.48 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $40.74 / $74.13
| Professional | | $19.95 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.20 / $38.02 / $67.61
| Professional | | $18.20 | $38.02 | $67.61 |