- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.46 / $53.46 / $73.37
| Professional | | $47.46 | $53.46 | $73.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.30 / $21.91 / $24.10
| Professional | 26 | $18.30 | $21.91 | $24.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.21 / $31.57 / $49.87
| Professional | TC | $27.21 | $31.57 | $49.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.74 / $206.09 / $213.72
| Professional | | $190.74 | $206.09 | $213.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $56.01 / $61.66 / $62.76
| Professional | 26 | $56.01 | $61.66 | $62.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $134.72 / $144.44 / $150.96
| Professional | TC | $134.72 | $144.44 | $150.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.32 / $105.32 / $131.63
| Professional | | $105.32 | $105.32 | $131.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.56 / $30.56 / $38.20
| Professional | 26 | $30.56 | $30.56 | $38.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $74.75 / $74.75 / $93.44
| Professional | TC | $74.75 | $74.75 | $93.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.58 / $152.86 / $466.08
| Professional | | $83.58 | $152.86 | $466.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.62 / $57.40 / $186.58
| Professional | 26 | $31.62 | $57.40 | $186.58 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $51.96 / $95.46 / $309.75
| Professional | TC | $51.96 | $95.46 | $309.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.79 / $71.04 / $152.86
| Professional | | $41.79 | $71.04 | $152.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.88 / $54.81 / $57.40
| Professional | 26 | $26.88 | $54.81 | $57.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $44.16 / $95.46 / $108.32
| Professional | TC | $44.16 | $95.46 | $108.32 |