- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.78 / $49.17 / $80.84
| Facility | | $32.78 | $49.17 | $80.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.24 / $12.35 / $14.01
| Facility | 26 | $8.24 | $12.35 | $14.01 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $24.53 / $36.81 / $215.60
| Facility | TC | $24.53 | $36.81 | $215.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.72 / $35.79 / $283.75
| Professional | | $25.72 | $35.79 | $283.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.07 / $9.67 / $72.29
| Professional | 26 | $7.07 | $9.67 | $72.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.19 / $24.54 / $66.78
| Professional | TC | $18.19 | $24.54 | $66.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.73 / $44.73 / $92.59
| Professional | | $44.73 | $44.73 | $92.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.18 / $11.18 / $23.14
| Professional | 26 | $11.18 | $11.18 | $23.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $33.21 / $33.21 / $68.73
| Professional | TC | $33.21 | $33.21 | $68.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $28.00 / $88.20
| Professional | | $19.64 | $28.00 | $88.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.80 / $7.95 / $27.91
| Professional | 26 | $4.80 | $7.95 | $27.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.21 / $22.32 / $61.18
| Professional | TC | $14.21 | $22.32 | $61.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.96 / $58.55 / $91.81
| Facility | | $37.96 | $58.55 | $91.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.76 / $61.24 / $165.09
| Professional | | $51.76 | $61.24 | $165.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.02 / $15.41 / $41.18
| Professional | 26 | $13.02 | $15.41 | $41.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $38.74 / $45.84 / $123.87
| Professional | TC | $38.74 | $45.84 | $123.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $36.79 / $96.92
| Professional | | $25.12 | $36.79 | $96.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.50 / $7.32 / $24.54
| Professional | 26 | $6.50 | $7.32 | $24.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.97 / $30.29 / $69.34
| Professional | TC | $17.97 | $30.29 | $69.34 |