- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $33.03 / $132.19
| Professional | | $17.48 | $33.03 | $132.19 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $8.33 / $9.51 / $16.52
| Professional | 52 | $8.33 | $9.51 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.18 / $26.84 / $56.00
| Professional | | $26.18 | $26.84 | $56.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.57 / $73.51 / $93.08
| Professional | | $50.57 | $73.51 | $93.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.01 / $21.74 / $41.62
| Professional | | $17.01 | $21.74 | $41.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.23 / $33.34 / $52.38
| Professional | | $22.23 | $33.34 | $52.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.81 / $23.94 / $31.00
| Professional | | $20.81 | $23.94 | $31.00 |