- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.09 / $25.36 / $28.71
| Professional | | $22.09 | $25.36 | $28.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.41 / $25.86 / $42.59
| Professional | | $23.41 | $25.86 | $42.59 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $35.11 / $38.79 / $62.07
| Professional | 50 | $35.11 | $38.79 | $62.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.02 / $30.40 / $57.46
| Professional | | $22.02 | $30.40 | $57.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.70 / $37.19 / $72.83
| Professional | | $19.70 | $37.19 | $72.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.91 / $32.40 / $62.27
| Professional | | $18.91 | $32.40 | $62.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.51 / $23.41 / $30.09
| Professional | | $19.51 | $23.41 | $30.09 |