- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.53 / $38.61 / $41.98
| Professional | | $33.53 | $38.61 | $41.98 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.77 / $19.30 / $20.99
| Professional | 52 | $16.77 | $19.30 | $20.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.12 / $31.22 / $55.82
| Professional | | $29.12 | $31.22 | $55.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.06 / $60.87 / $62.70
| Professional | | $46.06 | $60.87 | $62.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.73 / $35.20 / $87.56
| Professional | | $25.73 | $35.20 | $87.56 |