- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $44.67 / $97.72
| Professional | | $28.18 | $44.67 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $48.98 / $48.98 / $48.98
| Professional | 52 | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $91.20 / $102.33
| Professional | | $67.61 | $91.20 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $75.86 / $128.82
| Professional | | $28.84 | $75.86 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $70.79 / $102.33
| Professional | | $30.90 | $70.79 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $38.90 / $38.90 / $63.10
| Professional | 52 | $38.90 | $38.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $44.67 / $75.86
| Professional | | $28.84 | $44.67 | $75.86 |