- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.61 / $58.30 / $608.29
| Facility | | $26.61 | $58.30 | $608.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.66 / $12.66 / $12.66
| Facility | 26 | $12.66 | $12.66 | $12.66 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $26.61 / $26.61 / $31.46
| Facility | TC | $26.61 | $26.61 | $31.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.93 / $44.11 / $55.25
| Professional | | $30.93 | $44.11 | $55.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.41 / $11.29 / $12.66
| Professional | 26 | $8.41 | $11.29 | $12.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.52 / $31.47 / $46.06
| Professional | TC | $22.52 | $31.47 | $46.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.36 / $37.39 / $43.52
| Professional | | $18.36 | $37.39 | $43.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.05 / $12.14 / $13.40
| Professional | 26 | $5.05 | $12.14 | $13.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.00 / $68.00 / $80.23
| Professional | | $68.00 | $68.00 | $80.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.25 / $21.50 / $25.37
| Professional | 26 | $20.25 | $21.50 | $25.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $46.50 / $46.50 / $54.87
| Professional | TC | $46.50 | $46.50 | $54.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.80 / $25.86 / $68.77
| Professional | | $18.80 | $25.86 | $68.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.13 / $5.79 / $29.22
| Professional | 26 | $5.13 | $5.79 | $29.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.60 / $15.46 / $55.42
| Professional | TC | $13.60 | $15.46 | $55.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.78 / $41.86 / $62.79
| Professional | | $22.78 | $41.86 | $62.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.84 / $8.69 / $11.91
| Professional | 26 | $6.84 | $8.69 | $11.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.94 / $26.57 / $44.92
| Professional | TC | $15.94 | $26.57 | $44.92 |