- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.63 / $42.98 / $55.79
| Professional | | $33.63 | $42.98 | $55.79 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.82 / $21.21 / $25.68
| Professional | 52 | $16.82 | $21.21 | $25.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.61 / $37.11 / $71.09
| Professional | | $30.61 | $37.11 | $71.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.45 / $45.16 / $76.38
| Professional | | $29.45 | $45.16 | $76.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.00 / $45.21 / $76.58
| Facility | | $33.00 | $45.21 | $76.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.49 / $36.29 / $48.51
| Professional | | $27.49 | $36.29 | $48.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.58 / $44.09 / $53.77
| Professional | | $32.58 | $44.09 | $53.77 |