- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.66 / $534.72 / $570.09
| Facility | | $66.66 | $534.72 | $570.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.60 / $42.38 / $156.10
| Professional | | $11.60 | $42.38 | $156.10 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $5.65 / $8.24 / $25.52
| Professional | 52 | $5.65 | $8.24 | $25.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.39 / $81.54 / $94.41
| Facility | | $73.39 | $81.54 | $94.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.84 / $30.58 / $64.31
| Professional | | $13.84 | $30.58 | $64.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.32 / $41.96 / $81.81
| Professional | | $17.32 | $41.96 | $81.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.27 / $54.00 / $70.98
| Professional | | $38.27 | $54.00 | $70.98 |