- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.57 / $25.34 / $34.32
| Professional | | $18.57 | $25.34 | $34.32 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.28 / $12.67 / $17.16
| Professional | 52 | $9.28 | $12.67 | $17.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.36 / $36.13 / $53.04
| Professional | | $21.36 | $36.13 | $53.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.78 / $26.18 / $41.42
| Professional | | $16.78 | $26.18 | $41.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.92 / $40.20 / $68.02
| Professional | | $30.92 | $40.20 | $68.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.60 / $26.13 / $52.22
| Professional | | $17.60 | $26.13 | $52.22 |