- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.82 / $184.98 / $893.63
| Facility | | $15.82 | $184.98 | $893.63 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $8.17 / $9.73 / $30.79
| Facility | 52 | $8.17 | $9.73 | $30.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.81 / $33.97 / $61.58
| Professional | | $12.81 | $33.97 | $61.58 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $6.81 / $12.53 / $30.79
| Professional | 52 | $6.81 | $12.53 | $30.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.60 / $12.36 / $37.31
| Professional | | $8.60 | $12.36 | $37.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.34 / $17.34 / $57.38
| Professional | | $17.34 | $17.34 | $57.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.69 / $36.65 / $69.13
| Professional | | $13.69 | $36.65 | $69.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.62 / $32.92 / $67.12
| Facility | | $13.62 | $32.92 | $67.12 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $42.38 / $42.38 / $42.38
| Facility | 52 | $42.38 | $42.38 | $42.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.78 / $60.23 / $243.34
| Professional | | $40.78 | $60.23 | $243.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.27 / $50.53 / $70.87
| Professional | | $40.27 | $50.53 | $70.87 |