- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.26 / $25.35 / $45.47
| Professional | | $18.26 | $25.35 | $45.47 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $8.51 / $11.85 / $17.30
| Professional | 52 | $8.51 | $11.85 | $17.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.09 / $26.41 / $43.02
| Professional | | $19.09 | $26.41 | $43.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.71 / $18.34 / $19.75
| Professional | | $15.71 | $18.34 | $19.75 |
- 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
- $17.55 / $26.57 / $51.83
| Professional | | $17.55 | $26.57 | $51.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.17 / $29.61 / $35.53
| Professional | | $25.17 | $29.61 | $35.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.01 / $29.14 / $44.80
| Facility | | $21.01 | $29.14 | $44.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.00 / $38.00 / $51.00
| Professional | | $33.00 | $38.00 | $51.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.42 / $23.12 / $33.02
| Facility | | $19.42 | $23.12 | $33.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.12 / $30.64 / $41.53
| Professional | | $26.12 | $30.64 | $41.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.91 / $22.52 / $36.77
| Professional | | $17.91 | $22.52 | $36.77 |