- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.95 / $23.99 / $33.11
| Professional | | $19.95 | $23.99 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.98 / $19.95 / $25.70
| Professional | 26 | $16.98 | $19.95 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.02 / $3.98 / $6.03
| Professional | TC | $3.02 | $3.98 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $57.54 / $64.57
| Professional | | $42.66 | $57.54 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.48 / $47.86 / $53.70
| Professional | 26 | $35.48 | $47.86 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.41 / $10.00 / $11.22
| Professional | TC | $7.41 | $10.00 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $47.86 / $85.11
| Professional | | $21.88 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.20 / $39.81 / $70.79
| Professional | 26 | $18.20 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.55 / $7.59 / $13.80
| Professional | TC | $3.55 | $7.59 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $34.67 / $316.23
| Professional | | $21.88 | $34.67 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.20 / $30.20 / $158.49
| Professional | 26 | $18.20 | $30.20 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.09 / $5.50 / $218.78
| Professional | TC | $3.09 | $5.50 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $32.36 / $53.70
| Professional | | $21.88 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.20 / $27.54 / $44.67
| Professional | 26 | $18.20 | $27.54 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.72 / $5.25 / $8.71
| Professional | TC | $3.72 | $5.25 | $8.71 |