- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.62 / $68.14 / $71.79
| Professional | | $43.62 | $68.14 | $71.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.81 / $11.34 / $11.92
| Professional | 26 | $6.81 | $11.34 | $11.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $36.38 / $56.21 / $60.45
| Professional | TC | $36.38 | $56.21 | $60.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.02 / $22.07 / $57.71
| Professional | | $6.02 | $22.07 | $57.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.60 / $64.95 / $93.03
| Professional | | $41.60 | $64.95 | $93.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.97 / $12.19 / $15.78
| Professional | 26 | $6.97 | $12.19 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.29 / $52.75 / $76.52
| Professional | TC | $34.29 | $52.75 | $76.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.05 / $61.67 / $83.25
| Professional | | $12.05 | $61.67 | $83.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.60 / $64.95 / $93.03
| Professional | | $41.60 | $64.95 | $93.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.31 / $12.19 / $15.60
| Professional | 26 | $7.31 | $12.19 | $15.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.29 / $52.75 / $74.40
| Professional | TC | $34.29 | $52.75 | $74.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.40 / $62.58 / $90.48
| Professional | | $41.40 | $62.58 | $90.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.36 / $11.44 / $15.07
| Professional | 26 | $8.36 | $11.44 | $15.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.46 / $53.76 / $75.95
| Professional | TC | $34.46 | $53.76 | $75.95 |