- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.29 / $59.93 / $108.60
| Professional | | $46.29 | $59.93 | $108.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $139.03 / $139.03 / $139.03
| Professional | 50 | $139.03 | $139.03 | $139.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.49 / $58.07 / $125.56
| Professional | | $41.49 | $58.07 | $125.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $62.23 / $87.10 / $188.34
| Professional | 50 | $62.23 | $87.10 | $188.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.44 / $72.14 / $112.53
| Professional | | $49.44 | $72.14 | $112.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.46 / $72.40 / $151.49
| Professional | | $46.46 | $72.40 | $151.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.98 / $73.83 / $120.26
| Professional | | $46.98 | $73.83 | $120.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.31 / $76.13 / $102.79
| Professional | | $56.31 | $76.13 | $102.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.60 / $67.01 / $135.59
| Professional | | $54.60 | $67.01 | $135.59 |