- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.82 / $35.01 / $52.04
| Professional | | $23.82 | $35.01 | $52.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.35 / $23.72 / $29.08
| Professional | 26 | $19.35 | $23.72 | $29.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.90 / $5.93 / $26.54
| Professional | TC | $3.90 | $5.93 | $26.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.90 / $36.06 / $49.28
| Professional | | $21.90 | $36.06 | $49.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.77 / $30.33 / $38.11
| Professional | 26 | $18.77 | $30.33 | $38.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.57 / $5.73 / $7.83
| Professional | TC | $3.57 | $5.73 | $7.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.17 / $40.03 / $48.52
| Professional | | $27.17 | $40.03 | $48.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.46 / $33.08 / $48.52
| Professional | 26 | $22.46 | $33.08 | $48.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $4.72 / $6.95 / $8.42
| Professional | TC | $4.72 | $6.95 | $8.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.69 / $32.34 / $40.13
| Professional | | $5.69 | $32.34 | $40.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.88 / $37.31 / $41.82
| Professional | | $31.88 | $37.31 | $41.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.35 / $30.85 / $35.19
| Professional | 26 | $26.35 | $30.85 | $35.19 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $5.53 / $6.47 / $6.80
| Professional | TC | $5.53 | $6.47 | $6.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.52 / $34.54 / $49.50
| Professional | | $26.52 | $34.54 | $49.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.11 / $25.37 / $34.79
| Professional | 26 | $17.11 | $25.37 | $34.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.88 / $7.06 / $21.93
| Professional | TC | $3.88 | $7.06 | $21.93 |