- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.63 / $48.68 / $60.42
| Professional | | $33.63 | $48.68 | $60.42 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.82 / $24.34 / $30.21
| Professional | 52 | $16.82 | $24.34 | $30.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.61 / $42.64 / $69.73
| Professional | | $5.61 | $42.64 | $69.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.83 / $46.18 / $68.48
| Professional | | $31.83 | $46.18 | $68.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.54 / $43.74 / $67.15
| Professional | | $0.54 | $43.74 | $67.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.63 / $49.17 / $80.45
| Professional | | $37.63 | $49.17 | $80.45 |