- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.60 / $13.23 / $1,678.00
| Facility | | $11.60 | $13.23 | $1,678.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5.80 / $5.86 / $6.62
| Facility | 52 | $5.80 | $5.86 | $6.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.72 / $15.31 / $47.78
| Professional | | $11.72 | $15.31 | $47.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.86 / $16.53 / $24.22
| Professional | | $12.86 | $16.53 | $24.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $12.23 / $12.23 / $12.23
| Facility | 52 | $12.23 | $12.23 | $12.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.46 / $19.72 / $39.59
| Professional | | $12.46 | $19.72 | $39.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.73 / $14.66 / $14.66
| Facility | | $12.73 | $14.66 | $14.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.47 / $10.37 / $19.12
| Professional | | $9.47 | $10.37 | $19.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.79 / $17.15 / $25.76
| Professional | | $11.79 | $17.15 | $25.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.82 / $15.38 / $28.68
| Professional | | $10.82 | $15.38 | $28.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $10.72 / $10.72
| Professional | | $10.72 | $10.72 | $10.72 |