- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.32 / $24.75 / $34.61
| Professional | | $19.32 | $24.75 | $34.61 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.27 / $12.38 / $17.30
| Professional | 52 | $9.27 | $12.38 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.29 / $18.34 / $20.14
| Professional | | $14.29 | $18.34 | $20.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.41 / $27.31 / $73.11
| Professional | | $16.41 | $27.31 | $73.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.13 / $32.57 / $62.75
| Professional | | $28.13 | $32.57 | $62.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.64 / $22.46 / $65.23
| Professional | | $18.64 | $22.46 | $65.23 |