- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.69 / $27.51 / $34.93
| Professional | | $19.69 | $27.51 | $34.93 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.78 / $13.47 / $17.16
| Professional | 52 | $9.78 | $13.47 | $17.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.55 / $37.85 / $43.99
| Professional | | $26.55 | $37.85 | $43.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.00 / $22.00 / $37.00
| Professional | | $16.00 | $22.00 | $37.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.42 / $29.30 / $45.62
| Professional | | $18.42 | $29.30 | $45.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $27.85 / $162.13
| Professional | | $16.73 | $27.85 | $162.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.03 / $26.60 / $48.63
| Professional | | $17.03 | $26.60 | $48.63 |