- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.43 / $16.51 / $81.73
| Facility | | $14.43 | $16.51 | $81.73 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $7.22 / $8.26 / $40.86
| Facility | 52 | $7.22 | $8.26 | $40.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.22 / $17.44 / $28.61
| Professional | | $13.22 | $17.44 | $28.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $17.05 / $18.37
| Professional | | $13.12 | $17.05 | $18.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.18 / $15.78 / $21.96
| Professional | | $13.18 | $15.78 | $21.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.12 / $15.74 / $20.99
| Facility | | $13.12 | $15.74 | $20.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.12 / $15.74 / $21.65
| Professional | | $13.12 | $15.74 | $21.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.85 / $15.85 / $20.22
| Facility | | $15.85 | $15.85 | $20.22 |
- 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
- $13.28 / $20.89 / $32.38
| Professional | | $13.28 | $20.89 | $32.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.37 / $32.34 / $32.34
| Professional | | $18.37 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.86 / $18.05 / $28.30
| Professional | | $13.86 | $18.05 | $28.30 |