- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.55 / $26.86 / $66.75
| Professional | | $18.55 | $26.86 | $66.75 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $8.97 / $12.38 / $17.30
| Professional | 52 | $8.97 | $12.38 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.51 / $18.34 / $20.14
| Professional | | $16.51 | $18.34 | $20.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.12 / $23.92 / $45.67
| Professional | | $16.12 | $23.92 | $45.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.24 / $31.76 / $57.98
| Professional | | $26.24 | $31.76 | $57.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.64 / $23.98 / $41.29
| Professional | | $18.64 | $23.98 | $41.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.51 / $21.63 / $29.61
| Professional | | $21.51 | $21.63 | $29.61 |