- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.53 / $40.83 / $55.89
| Professional | | $33.53 | $40.83 | $55.89 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.77 / $18.17 / $27.95
| Professional | 52 | $16.77 | $18.17 | $27.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.10 / $52.55 / $78.41
| Professional | | $32.10 | $52.55 | $78.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.09 / $29.37 / $37.72
| Professional | | $23.09 | $29.37 | $37.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.22 / $58.65 / $63.27
| Professional | | $52.22 | $58.65 | $63.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.86 / $36.04 / $57.63
| Professional | | $26.86 | $36.04 | $57.63 |