- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.21 / $24.36 / $41.77
| Professional | | $17.21 | $24.36 | $41.77 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $8.51 / $11.42 / $15.14
| Professional | 52 | $8.51 | $11.42 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.75 / $24.46 / $32.47
| Professional | | $22.75 | $24.46 | $32.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.64 / $24.20 / $39.15
| Professional | | $17.64 | $24.20 | $39.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18.50 / $20.35 / $26.83
| Facility | | $18.50 | $20.35 | $26.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.46 / $24.97 / $35.78
| Professional | | $24.46 | $24.97 | $35.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.38 / $32.38 / $32.38
| Facility | | $32.38 | $32.38 | $32.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.57 / $26.06 / $51.61
| Professional | | $17.57 | $26.06 | $51.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.16 / $32.34 / $32.34
| Professional | | $14.16 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.57 / $23.47 / $44.45
| Professional | | $20.57 | $23.47 | $44.45 |