- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.80 / $16.98 / $34.67
| Professional | | $13.80 | $16.98 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.91 / $21.88 / $95.50
| Professional | 26 | $8.91 | $21.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.01 / $7.08 / $15.85
| Professional | TC | $5.01 | $7.08 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.33 / $9.33 / $18.62
| Professional | | $9.33 | $9.33 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.62 / $12.02 / $12.88
| Professional | 26 | $5.62 | $12.02 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.79 / $19.95 / $21.88
| Professional | | $14.79 | $19.95 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $11.75 / $25.70
| Professional | 26 | $10.96 | $11.75 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.76 / $8.13 / $8.13
| Professional | TC | $7.76 | $8.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.32 / $10.23 / $25.70
| Professional | | $8.32 | $10.23 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.62 / $6.31 / $19.05
| Professional | 26 | $5.62 | $6.31 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.40 / $4.07 / $8.71
| Professional | TC | $2.40 | $4.07 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.79 / $19.95 / $33.11
| Facility | | $14.79 | $19.95 | $33.11 |
- 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
- $10.72 / $16.98 / $41.69
| Professional | | $10.72 | $16.98 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.92 / $10.96 / $27.54
| Professional | 26 | $6.92 | $10.96 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.80 / $5.62 / $13.49
| Professional | TC | $3.80 | $5.62 | $13.49 |