- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.39 / $76.23 / $136.29
| Professional | | $59.39 | $76.23 | $136.29 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $32.63 / $38.11 / $58.54
| Professional | 52 | $32.63 | $38.11 | $58.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.48 / $87.62 / $99.35
| Professional | | $74.48 | $87.62 | $99.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.60 / $143.69 / $149.41
| Professional | | $84.60 | $143.69 | $149.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.08 / $95.19 / $131.16
| Professional | | $70.08 | $95.19 | $131.16 |