- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.01 / $28.74 / $48.02
| Professional | | $22.01 | $28.74 | $48.02 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $10.18 / $11.01 / $14.16
| Professional | 52 | $10.18 | $11.01 | $14.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.00 / $36.00 / $49.00
| Professional | | $29.00 | $36.00 | $49.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.96 / $26.89 / $40.34
| Professional | | $16.96 | $26.89 | $40.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.41 / $40.56 / $48.36
| Professional | | $25.41 | $40.56 | $48.36 |