- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.96 / $20.42 / $51.29
| Facility | | $10.96 | $20.42 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.08 / $7.94 / $13.49
| Facility | 26 | $7.08 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $12.88 / $33.88
| Professional | | $8.91 | $12.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.03 / $7.59 / $16.22
| Professional | 26 | $6.03 | $7.59 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.00 / $3.02 / $6.03
| Professional | TC | $2.00 | $3.02 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $26.30 / $28.84
| Professional | | $19.95 | $26.30 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.49 / $17.78 / $19.95
| Professional | 26 | $13.49 | $17.78 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.46 / $8.51 / $9.33
| Professional | TC | $6.46 | $8.51 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $19.05 / $28.84
| Professional | | $12.02 | $19.05 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.59 / $12.59 / $19.95
| Professional | 26 | $7.59 | $12.59 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.24 / $6.17 / $9.55
| Professional | TC | $3.24 | $6.17 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.02 / $17.78 / $31.62
| Facility | | $12.02 | $17.78 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.30 / $23.99 / $1,412.54
| Professional | | $12.30 | $23.99 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.32 / $15.85 / $1,288.25
| Professional | 26 | $8.32 | $15.85 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.98 / $7.59 / $977.24
| Professional | TC | $3.98 | $7.59 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $56.23 / $56.23
| Facility | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $21.38 / $30.20
| Professional | | $12.02 | $21.38 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.32 / $14.13 / $20.42
| Professional | 26 | $8.32 | $14.13 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.39 / $6.92 / $10.00
| Professional | TC | $3.39 | $6.92 | $10.00 |