- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.39 / $26.42 / $52.15
| Professional | | $22.39 | $26.42 | $52.15 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $9.78 / $12.67 / $14.17
| Professional | 52 | $9.78 | $12.67 | $14.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.53 / $30.64 / $59.19
| Professional | | $25.53 | $30.64 | $59.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.86 / $28.89 / $50.38
| Professional | | $18.86 | $28.89 | $50.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.94 / $37.61 / $39.28
| Professional | | $35.94 | $37.61 | $39.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.56 / $17.73 / $30.62
| Professional | | $13.56 | $17.73 | $30.62 |