- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.01 / $53.21 / $71.79
| Professional | | $44.01 | $53.21 | $71.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.15 / $8.42 / $10.68
| Professional | 26 | $7.15 | $8.42 | $10.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $36.86 / $43.17 / $51.69
| Professional | TC | $36.86 | $43.17 | $51.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.61 / $42.17 / $71.54
| Professional | | $36.61 | $42.17 | $71.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.10 / $7.63 / $11.69
| Professional | 26 | $6.10 | $7.63 | $11.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.51 / $35.14 / $59.84
| Professional | TC | $30.51 | $35.14 | $59.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.95 / $50.12 / $71.63
| Professional | | $26.95 | $50.12 | $71.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.27 / $9.82 / $12.29
| Professional | 26 | $7.27 | $9.82 | $12.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.03 / $41.87 / $60.85
| Professional | TC | $19.03 | $41.87 | $60.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $0.77 / $66.68 / $95.24
| Professional | | $0.77 | $66.68 | $95.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $0.35 / $10.38 / $14.93
| Professional | 26 | $0.35 | $10.38 | $14.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $0.42 / $56.29 / $80.31
| Professional | TC | $0.42 | $56.29 | $80.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.04 / $50.66 / $81.64
| Professional | | $41.04 | $50.66 | $81.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.74 / $9.10 / $14.32
| Professional | 26 | $7.74 | $9.10 | $14.32 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $32.59 / $41.82 / $68.88
| Professional | TC | $32.59 | $41.82 | $68.88 |