- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.78 / $31.06 / $32.84
| Professional | | $26.78 | $31.06 | $32.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.46 / $9.72 / $10.03
| Professional | 26 | $8.46 | $9.72 | $10.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.32 / $21.02 / $23.53
| Professional | TC | $18.32 | $21.02 | $23.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.95 / $42.37 / $140.28
| Professional | | $35.95 | $42.37 | $140.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.48 / $11.48 / $38.03
| Professional | 26 | $11.48 | $11.48 | $38.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.47 / $24.47 / $28.96
| Professional | TC | $24.47 | $24.47 | $28.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.52 / $48.61 / $140.28
| Professional | | $38.52 | $48.61 | $140.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.55 / $13.06 / $38.03
| Professional | 26 | $12.55 | $13.06 | $38.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.97 / $31.48 / $50.30
| Professional | TC | $25.97 | $31.48 | $50.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.52 / $46.69 / $140.28
| Professional | | $38.52 | $46.69 | $140.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.55 / $13.06 / $38.03
| Professional | 26 | $12.55 | $13.06 | $38.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.97 / $29.43 / $49.93
| Professional | TC | $25.97 | $29.43 | $49.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.11 / $44.83 / $120.08
| Professional | | $32.11 | $44.83 | $120.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.74 / $13.93 / $36.08
| Professional | 26 | $9.74 | $13.93 | $36.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.26 / $30.27 / $108.76
| Professional | TC | $21.26 | $30.27 | $108.76 |