- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.23 / $93.64 / $139.85
| Professional | | $76.23 | $93.64 | $139.85 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $38.11 / $39.84 / $39.84
| Professional | 52 | $38.11 | $39.84 | $39.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.78 / $103.01 / $188.98
| Professional | | $73.78 | $103.01 | $188.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.89 / $117.01 / $155.69
| Professional | | $86.89 | $117.01 | $155.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.27 / $104.44 / $245.99
| Professional | | $90.27 | $104.44 | $245.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.67 / $93.64 / $138.33
| Professional | | $79.67 | $93.64 | $138.33 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $38.11 / $39.84 / $48.03
| Professional | 52 | $38.11 | $39.84 | $48.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.76 / $105.08 / $146.86
| Professional | | $67.76 | $105.08 | $146.86 |