- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.11 / $57.09 / $74.77
| Professional | | $46.11 | $57.09 | $74.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.85 / $70.34 / $96.32
| Professional | | $51.85 | $70.34 | $96.32 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $77.77 / $105.51 / $144.47
| Professional | 50 | $77.77 | $105.51 | $144.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.10 / $73.94 / $267.61
| Professional | | $46.10 | $73.94 | $267.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.91 / $81.48 / $1,845.40
| Professional | | $59.91 | $81.48 | $1,845.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.82 / $74.78 / $120.02
| Professional | | $57.82 | $74.78 | $120.02 |