- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65.03 / $342.00 / $7,433.00
| Facility | | $65.03 | $342.00 | $7,433.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.98 / $14.83 / $37.79
| Professional | | $10.98 | $14.83 | $37.79 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $21.29 / $38.29 / $86.49
| Professional | 50 | $21.29 | $38.29 | $86.49 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $5.32 / $5.89 / $8.28
| Professional | 52 | $5.32 | $5.89 | $8.28 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $2.13 / $2.36 / $3.31
| Professional | 53 | $2.13 | $2.36 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $14.96 / $41.00
| Professional | | $13.45 | $14.96 | $41.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $20.17 / $26.03 / $65.06
| Professional | 50 | $20.17 | $26.03 | $65.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $323.00 / $323.00
| Facility | | $323.00 | $323.00 | $323.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.89 / $17.57 / $27.74
| Professional | | $11.89 | $17.57 | $27.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.00 / $1,753.00 / $3,070.00
| Facility | | $1,189.00 | $1,753.00 | $3,070.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.19 / $10.85 / $19.07
| Professional | | $9.19 | $10.85 | $19.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.60 / $21.01 / $24.75
| Professional | | $9.60 | $21.01 | $24.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.00 / $1,911.00 / $4,970.00
| Facility | | $345.00 | $1,911.00 | $4,970.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.45 / $15.60 / $27.33
| Professional | | $10.45 | $15.60 | $27.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.00 / $12.00 / $12.00
| Professional | | $12.00 | $12.00 | $12.00 |