- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.96 / $13.49 / $30.20
| Professional | | $10.96 | $13.49 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $3.02 / $4.37 / $24.55
| Professional | 26 | $3.02 | $4.37 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.08 / $8.91 / $22.91
| Professional | TC | $7.08 | $8.91 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.59 / $7.59 / $7.59
| Professional | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.04 / $4.37 / $4.68
| Professional | 26 | $2.04 | $4.37 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $16.22 / $34.67
| Professional | | $9.12 | $16.22 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.17 / $4.47 / $22.91
| Professional | 26 | $4.17 | $4.47 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.96 / $11.75 / $20.42
| Professional | TC | $10.96 | $11.75 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.24 / $10.23 / $28.18
| Professional | | $7.24 | $10.23 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $1.95 / $2.19 / $6.31
| Professional | 26 | $1.95 | $2.19 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.13 / $8.13 / $21.88
| Professional | TC | $5.13 | $8.13 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.22 / $15.14 / $39.81
| Facility | | $11.22 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.91 / $15.14 / $46.77
| Professional | | $8.91 | $15.14 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.45 / $3.98 / $9.33
| Professional | 26 | $2.45 | $3.98 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.17 / $11.22 / $38.02
| Professional | TC | $6.17 | $11.22 | $38.02 |