- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.45 / $15.14 / $34.53
| Professional | | $13.45 | $15.14 | $34.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $3.76 / $4.11 / $4.71
| Professional | 26 | $3.76 | $4.11 | $4.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.29 / $10.95 / $29.82
| Professional | TC | $7.29 | $10.95 | $29.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.33 / $7.33 / $7.75
| Professional | | $7.33 | $7.33 | $7.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $1.97 / $2.06 / $6.83
| Professional | 26 | $1.97 | $2.06 | $6.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.88 / $20.88 / $60.29
| Professional | | $20.88 | $20.88 | $60.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.74 / $27.68 / $46.00
| Professional | | $7.74 | $27.68 | $46.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.27 / $5.78 / $15.00
| Professional | 26 | $2.27 | $5.78 | $15.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.46 / $22.26 / $31.00
| Professional | TC | $5.46 | $22.26 | $31.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.58 / $19.21 / $40.86
| Facility | | $13.58 | $19.21 | $40.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.07 / $22.23 / $122.00
| Professional | | $15.07 | $22.23 | $122.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.34 / $6.16 / $87.52
| Professional | 26 | $4.34 | $6.16 | $87.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.53 / $17.80 / $97.85
| Professional | TC | $10.53 | $17.80 | $97.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.51 / $15.88 / $22.23
| Professional | | $10.51 | $15.88 | $22.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.82 / $4.63 / $6.39
| Professional | 26 | $2.82 | $4.63 | $6.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.77 / $11.19 / $17.95
| Professional | TC | $7.77 | $11.19 | $17.95 |