- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.81 / $41.69 / $58.55
| Professional | | $32.81 | $41.69 | $58.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.10 / $24.16 / $393.62
| Professional | 26 | $19.10 | $24.16 | $393.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.91 / $18.23 / $26.89
| Professional | TC | $12.91 | $18.23 | $26.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.93 / $56.93 / $117.28
| Professional | | $56.93 | $56.93 | $117.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.83 / $30.83 / $63.52
| Professional | 26 | $30.83 | $30.83 | $63.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.09 / $26.09 / $53.75
| Professional | TC | $26.09 | $26.09 | $53.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.51 / $28.29 / $93.45
| Professional | | $17.51 | $28.29 | $93.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.06 / $19.42 / $69.87
| Professional | 26 | $13.06 | $19.42 | $69.87 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $4.45 / $11.91 / $37.53
| Professional | TC | $4.45 | $11.91 | $37.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.64 / $54.85 / $79.53
| Facility | | $44.64 | $54.85 | $79.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.81 / $77.89 / $207.01
| Professional | | $65.81 | $77.89 | $207.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.26 / $41.72 / $110.29
| Professional | 26 | $35.26 | $41.72 | $110.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.56 / $36.17 / $96.71
| Professional | TC | $30.56 | $36.17 | $96.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.80 / $33.35 / $114.51
| Professional | | $23.80 | $33.35 | $114.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.53 / $19.60 / $66.20
| Professional | 26 | $17.53 | $19.60 | $66.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.27 / $14.98 / $46.20
| Professional | TC | $6.27 | $14.98 | $46.20 |