- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.48 / $24.48 / $40.02
| Professional | | $24.48 | $24.48 | $40.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.62 / $18.62 / $28.79
| Professional | 26 | $18.62 | $18.62 | $28.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.86 / $5.86 / $11.22
| Professional | TC | $5.86 | $5.86 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.63 / $45.80 / $83.94
| Professional | | $11.63 | $45.80 | $83.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.72 / $34.34 / $40.04
| Professional | 26 | $8.72 | $34.34 | $40.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.91 / $11.45 / $15.89
| Professional | TC | $2.91 | $11.45 | $15.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.12 / $33.20 / $54.44
| Professional | | $23.12 | $33.20 | $54.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.64 / $22.96 / $49.59
| Professional | 26 | $13.64 | $22.96 | $49.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $4.57 / $8.51 / $16.59
| Professional | TC | $4.57 | $8.51 | $16.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.68 / $42.45 / $65.12
| Professional | | $16.68 | $42.45 | $65.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.97 / $31.16 / $56.38
| Professional | 26 | $25.97 | $31.16 | $56.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.72 / $12.40 / $23.27
| Professional | TC | $10.72 | $12.40 | $23.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.48 / $27.38 / $69.55
| Professional | | $24.48 | $27.38 | $69.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.62 / $19.70 / $53.23
| Professional | 26 | $18.62 | $19.70 | $53.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.86 / $7.68 / $18.17
| Professional | TC | $5.86 | $7.68 | $18.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.62 / $30.77 / $73.45
| Professional | | $17.62 | $30.77 | $73.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.29 / $32.63 / $55.89
| Professional | 26 | $22.29 | $32.63 | $55.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.05 / $9.90 / $17.57
| Professional | TC | $5.05 | $9.90 | $17.57 |