- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.07 / $34.35 / $48.88
| Professional | | $24.07 | $34.35 | $48.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.01 / $24.21 / $34.09
| Professional | | $22.01 | $24.21 | $34.09 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $33.01 / $36.31 / $51.13
| Professional | 50 | $33.01 | $36.31 | $51.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.84 / $39.96 / $66.34
| Professional | | $23.84 | $39.96 | $66.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.26 / $36.27 / $60.66
| Professional | | $22.26 | $36.27 | $60.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.07 / $37.46 / $52.12
| Professional | | $24.07 | $37.46 | $52.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.08 / $40.31 / $59.67
| Professional | | $29.08 | $40.31 | $59.67 |