- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.46 / $64.89 / $77.80
| Professional | | $55.46 | $64.89 | $77.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.31 / $37.00 / $45.82
| Professional | 26 | $32.31 | $37.00 | $45.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.77 / $25.75 / $31.98
| Professional | TC | $21.77 | $25.75 | $31.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.09 / $73.09 / $86.16
| Professional | | $73.09 | $73.09 | $86.16 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.69 / $49.69 / $58.57
| Professional | 26 | $49.69 | $49.69 | $58.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.12 / $28.12 / $33.14
| Professional | TC | $28.12 | $28.12 | $33.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.86 / $65.90 / $144.02
| Professional | | $42.86 | $65.90 | $144.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.58 / $38.97 / $85.98
| Professional | 26 | $27.58 | $38.97 | $85.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.85 / $26.92 / $36.78
| Professional | TC | $15.85 | $26.92 | $36.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.86 / $65.90 / $118.71
| Professional | | $42.86 | $65.90 | $118.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.58 / $38.97 / $70.86
| Professional | 26 | $27.58 | $38.97 | $70.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.21 / $26.92 / $38.90
| Professional | TC | $17.21 | $26.92 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.91 / $76.43 / $138.61
| Professional | | $54.91 | $76.43 | $138.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.83 / $48.24 / $79.73
| Professional | 26 | $32.83 | $48.24 | $79.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.08 / $28.64 / $58.88
| Professional | TC | $22.08 | $28.64 | $58.88 |