- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.96 / $93.28 / $139.04
| Professional | | $36.96 | $93.28 | $139.04 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $22.81 / $22.81 / $22.81
| Professional | 52 | $22.81 | $22.81 | $22.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.60 / $108.60 / $108.60
| Professional | | $108.60 | $108.60 | $108.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.35 / $117.59 / $268.24
| Professional | | $47.35 | $117.59 | $268.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.30 / $81.06 / $81.06
| Professional | | $41.30 | $81.06 | $81.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.95 / $55.95 / $293.10
| Professional | | $55.95 | $55.95 | $293.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.79 / $103.75 / $203.50
| Professional | | $26.79 | $103.75 | $203.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.61 / $59.29 / $119.04
| Professional | | $48.61 | $59.29 | $119.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.88 / $78.88 / $125.41
| Professional | | $78.88 | $78.88 | $125.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.95 / $73.20 / $206.08
| Professional | | $55.95 | $73.20 | $206.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.85 / $45.00 / $120.27
| Professional | | $23.85 | $45.00 | $120.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.19 / $69.75 / $119.04
| Professional | | $57.19 | $69.75 | $119.04 |