- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.49 / $118.16 / $914.00
| Facility | | $12.49 | $118.16 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $8.51 / $8.51 / $27.08
| Facility | 52 | $8.51 | $8.51 | $27.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.83 / $40.03 / $45.07
| Professional | | $11.83 | $40.03 | $45.07 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $5.92 / $20.50 / $21.25
| Professional | 52 | $5.92 | $20.50 | $21.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.05 / $15.66 / $85.63
| Professional | | $13.05 | $15.66 | $85.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.32 / $33.24 / $55.86
| Professional | | $11.32 | $33.24 | $55.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.10 / $45.71 / $100.06
| Professional | | $16.10 | $45.71 | $100.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.85 / $40.36 / $113.29
| Professional | | $13.85 | $40.36 | $113.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.10 / $64.45 / $125.92
| Professional | | $47.10 | $64.45 | $125.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.09 / $32.07 / $48.11
| Professional | | $10.09 | $32.07 | $48.11 |