- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.63 / $46.83 / $63.30
| Professional | | $33.63 | $46.83 | $63.30 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.82 / $23.42 / $31.65
| Professional | 52 | $16.82 | $23.42 | $31.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.31 / $48.04 / $111.69
| Professional | | $31.31 | $48.04 | $111.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.38 / $46.92 / $58.35
| Professional | | $45.38 | $46.92 | $58.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.87 / $48.30 / $61.22
| Professional | | $28.87 | $48.30 | $61.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.73 / $34.65 / $83.54
| Professional | | $21.73 | $34.65 | $83.54 |