- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.68 / $18.57 / $73.84
| Facility | | $11.68 | $18.57 | $73.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $9.89 / $12.84
| Facility | 26 | $7.94 | $9.89 | $12.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.66 / $13.76 / $22.48
| Professional | | $9.66 | $13.76 | $22.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.45 / $9.49 / $12.38
| Professional | 26 | $6.45 | $9.49 | $12.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.05 / $4.28 / $6.50
| Professional | TC | $3.05 | $4.28 | $6.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.28 / $44.14 / $75.08
| Facility | | $9.28 | $44.14 | $75.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.16 / $16.55 / $27.62
| Professional | | $12.16 | $16.55 | $27.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.91 / $10.69 / $16.46
| Professional | 26 | $8.91 | $10.69 | $16.46 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.74 / $4.66 / $9.60
| Professional | TC | $3.74 | $4.66 | $9.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.14 / $11.09 / $11.27
| Facility | | $10.14 | $11.09 | $11.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.97 / $7.78 / $8.02
| Professional | 26 | $6.97 | $7.78 | $8.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.00 / $13.57 / $23.16
| Facility | | $7.00 | $13.57 | $23.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.85 / $12.35 / $23.36
| Professional | | $6.85 | $12.35 | $23.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.74 / $8.03 / $16.80
| Professional | 26 | $4.74 | $8.03 | $16.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.11 / $3.50 / $8.11
| Professional | TC | $2.11 | $3.50 | $8.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.92 / $39.01 / $68.40
| Facility | | $26.92 | $39.01 | $68.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.34 / $12.42 / $21.37
| Professional | | $9.34 | $12.42 | $21.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.48 / $8.69 / $15.35
| Professional | 26 | $6.48 | $8.69 | $15.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.83 / $3.97 / $6.26
| Professional | TC | $2.83 | $3.97 | $6.26 |