- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.67 / $27.55 / $49.31
| Professional | | $20.67 | $27.55 | $49.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.64 / $20.03 / $29.03
| Professional | 26 | $17.64 | $20.03 | $29.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $1.32 / $4.83 / $27.73
| Professional | TC | $1.32 | $4.83 | $27.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.07 / $36.29 / $67.48
| Professional | | $22.07 | $36.29 | $67.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.09 / $28.17 / $36.20
| Professional | 26 | $18.09 | $28.17 | $36.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.51 / $7.27 / $31.28
| Professional | TC | $3.51 | $7.27 | $31.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.54 / $64.84 / $89.91
| Professional | | $28.54 | $64.84 | $89.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.68 / $31.05 / $55.01
| Professional | 26 | $21.68 | $31.05 | $55.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.17 / $33.75 / $49.31
| Professional | TC | $5.17 | $33.75 | $49.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.78 / $28.78 / $72.67
| Professional | | $28.78 | $28.78 | $72.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.61 / $23.61 / $28.89
| Professional | 26 | $23.61 | $23.61 | $28.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.17 / $5.17 / $43.78
| Professional | TC | $5.17 | $5.17 | $43.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.89 / $37.38 / $71.72
| Professional | | $22.89 | $37.38 | $71.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.39 / $25.17 / $50.89
| Professional | 26 | $18.39 | $25.17 | $50.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.89 / $5.53 / $37.25
| Professional | TC | $3.89 | $5.53 | $37.25 |