- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.95 / $53.48 / $74.02
| Professional | | $35.95 | $53.48 | $74.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.55 / $24.32 / $33.35
| Professional | 26 | $16.55 | $24.32 | $33.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.39 / $29.17 / $40.68
| Professional | TC | $19.39 | $29.17 | $40.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.92 / $56.47 / $71.12
| Professional | | $48.92 | $56.47 | $71.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.31 / $24.91 / $31.20
| Professional | 26 | $21.31 | $24.91 | $31.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.60 / $31.56 / $40.13
| Professional | TC | $27.60 | $31.56 | $40.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.99 / $74.62 / $131.79
| Professional | | $42.99 | $74.62 | $131.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.59 / $28.27 / $57.69
| Professional | 26 | $20.59 | $28.27 | $57.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.01 / $41.38 / $74.09
| Professional | TC | $24.01 | $41.38 | $74.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $57.34 / $76.81
| Professional | | $32.36 | $57.34 | $76.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.11 / $25.14 / $30.86
| Professional | 26 | $19.11 | $25.14 | $30.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.75 / $32.56 / $43.34
| Professional | TC | $24.75 | $32.56 | $43.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.29 / $53.48 / $115.18
| Professional | | $48.29 | $53.48 | $115.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.36 / $24.32 / $47.69
| Professional | 26 | $21.36 | $24.32 | $47.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.52 / $29.17 / $62.84
| Professional | TC | $27.52 | $29.17 | $62.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.36 / $53.00 / $91.08
| Professional | | $38.36 | $53.00 | $91.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.50 / $25.34 / $39.11
| Professional | 26 | $18.50 | $25.34 | $39.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.33 / $26.55 / $42.38
| Professional | TC | $22.33 | $26.55 | $42.38 |