- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.63 / $46.00 / $57.49
| Professional | | $33.63 | $46.00 | $57.49 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.82 / $23.00 / $27.90
| Professional | 52 | $16.82 | $23.00 | $27.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.60 / $41.10 / $97.77
| Professional | | $39.60 | $41.10 | $97.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.11 / $53.11 / $53.11
| Facility | | $53.11 | $53.11 | $53.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.76 / $41.26 / $75.20
| Professional | | $30.76 | $41.26 | $75.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.49 / $58.66 / $58.66
| Professional | | $45.49 | $58.66 | $58.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.03 / $40.32 / $70.06
| Professional | | $38.03 | $40.32 | $70.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.77 / $50.48 / $107.95
| Professional | | $34.77 | $50.48 | $107.95 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.82 / $23.42 / $31.25
| Professional | 52 | $16.82 | $23.42 | $31.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.20 / $49.20 / $49.20
| Professional | | $49.20 | $49.20 | $49.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.11 / $53.11 / $53.11
| Facility | | $53.11 | $53.11 | $53.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.55 / $40.90 / $77.45
| Professional | | $30.55 | $40.90 | $77.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.39 / $40.17 / $55.44
| Professional | | $39.39 | $40.17 | $55.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.17 / $50.72 / $77.50
| Professional | | $33.17 | $50.72 | $77.50 |