- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.69 / $21.14 / $29.41
| Professional | | $19.69 | $21.14 | $29.41 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.81 / $10.57 / $14.71
| Professional | 52 | $9.81 | $10.57 | $14.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.00 / $25.67 / $29.08
| Professional | | $21.00 | $25.67 | $29.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.30 / $27.20 / $33.26
| Professional | | $15.30 | $27.20 | $33.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.89 / $29.44 / $33.64
| Professional | | $17.89 | $29.44 | $33.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.62 / $24.18 / $98.57
| Professional | | $20.62 | $24.18 | $98.57 |