- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.78 / $64.04 / $80.29
| Professional | | $49.78 | $64.04 | $80.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $28.98 / $35.54 / $44.41
| Professional | 26 | $28.98 | $35.54 | $44.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.80 / $25.80 / $34.90
| Professional | TC | $20.80 | $25.80 | $34.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.54 / $57.36 / $61.68
| Professional | | $52.54 | $57.36 | $61.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.13 / $62.08 / $82.79
| Professional | | $47.13 | $62.08 | $82.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.91 / $37.46 / $48.14
| Professional | 26 | $27.91 | $37.46 | $48.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.21 / $25.53 / $34.92
| Professional | TC | $19.21 | $25.53 | $34.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.06 / $60.18 / $84.53
| Professional | | $50.06 | $60.18 | $84.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.78 / $35.34 / $48.04
| Professional | 26 | $29.78 | $35.34 | $48.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.86 / $28.04 / $40.06
| Professional | TC | $20.86 | $28.04 | $40.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.55 / $76.37 / $102.50
| Professional | | $0.55 | $76.37 | $102.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $0.30 / $43.24 / $63.05
| Professional | 26 | $0.30 | $43.24 | $63.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $0.25 / $32.93 / $49.05
| Professional | TC | $0.25 | $32.93 | $49.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.26 / $61.34 / $105.22
| Professional | | $47.26 | $61.34 | $105.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.88 / $37.45 / $67.58
| Professional | 26 | $30.88 | $37.45 | $67.58 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.89 / $25.20 / $45.17
| Professional | TC | $19.89 | $25.20 | $45.17 |