- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.36 / $27.88 / $70.20
| Professional | | $19.36 | $27.88 | $70.20 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $10.56 / $11.14 / $15.32
| Professional | 52 | $10.56 | $11.14 | $15.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.41 / $50.88 / $69.26
| Professional | | $45.41 | $50.88 | $69.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.28 / $33.97 / $68.36
| Professional | | $14.28 | $33.97 | $68.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21.11 / $32.27 / $53.95
| Facility | | $21.11 | $32.27 | $53.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.34 / $44.58 / $126.34
| Professional | | $25.34 | $44.58 | $126.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.93 / $34.13 / $54.22
| Professional | | $23.93 | $34.13 | $54.22 |