- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.50 / $37.68 / $62.49
| Professional | | $35.50 | $37.68 | $62.49 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $17.10 / $17.97 / $28.93
| Professional | 52 | $17.10 | $17.97 | $28.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.77 / $47.84 / $120.42
| Professional | | $30.77 | $47.84 | $120.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.23 / $116.26 / $193.64
| Professional | | $104.23 | $116.26 | $193.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.46 / $56.00 / $135.58
| Professional | | $40.46 | $56.00 | $135.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.93 / $54.21 / $67.00
| Professional | | $31.93 | $54.21 | $67.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.02 / $50.23 / $103.59
| Professional | | $32.02 | $50.23 | $103.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $507.19 / $507.19 / $542.50
| Professional | | $507.19 | $507.19 | $542.50 |