- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.22 / $48.89 / $63.96
| Professional | | $33.22 | $48.89 | $63.96 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $17.10 / $18.76 / $33.72
| Professional | 52 | $17.10 | $18.76 | $33.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.11 / $33.08 / $86.36
| Professional | | $28.11 | $33.08 | $86.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.23 / $35.08 / $48.23
| Professional | | $29.23 | $35.08 | $48.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.02 / $101.17 / $348.89
| Professional | | $45.02 | $101.17 | $348.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $40.92
| Professional | | $32.34 | $32.34 | $40.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.15 / $55.69 / $97.28
| Professional | | $32.15 | $55.69 | $97.28 |