- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.42 / $562.34 / $1,737.80
| Facility | | $20.42 | $562.34 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.88 / $21.38 / $54.95
| Professional | | $12.88 | $21.38 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $17.38 / $33.88 / $85.11
| Professional | 50 | $17.38 | $33.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $13.80 / $13.80 / $13.80
| Professional | 52 | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $13.49 / $16.60
| Professional | | $10.96 | $13.49 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $15.49 / $23.44 / $30.90
| Professional | 50 | $15.49 | $23.44 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $181.97 / $245.47
| Facility | | $151.36 | $181.97 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.55 / $13.80 / $16.60
| Professional | | $9.55 | $13.80 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.49 / $15.49 / $24.55
| Professional | | $13.49 | $15.49 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $562.34 / $1,548.82
| Facility | | $218.78 | $562.34 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.23 / $12.88 / $21.38
| Professional | | $10.23 | $12.88 | $21.38 |