- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.57 / $25.34 / $32.94
| Professional | | $19.57 | $25.34 | $32.94 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.78 / $12.67 / $16.47
| Professional | 52 | $9.78 | $12.67 | $16.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.48 / $25.48 / $28.03
| Professional | | $25.48 | $25.48 | $28.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.32 / $20.90 / $72.65
| Professional | | $15.32 | $20.90 | $72.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.72 / $20.55 / $26.60
| Professional | | $15.72 | $20.55 | $26.60 |