- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.61 / $27.69 / $27.69
| Professional | | $25.61 | $27.69 | $27.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.47 / $23.01 / $23.01
| Professional | 26 | $21.47 | $23.01 | $23.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $4.13 / $4.68 / $4.68
| Professional | TC | $4.13 | $4.68 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.25 / $58.02 / $63.61
| Professional | | $48.25 | $58.02 | $63.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.89 / $47.96 / $52.58
| Professional | 26 | $39.89 | $47.96 | $52.58 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $8.47 / $10.05 / $11.02
| Professional | TC | $8.47 | $10.05 | $11.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.80 / $48.81 / $81.87
| Professional | | $21.80 | $48.81 | $81.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.27 / $40.01 / $68.59
| Professional | 26 | $18.27 | $40.01 | $68.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.54 / $7.74 / $13.28
| Professional | TC | $3.54 | $7.74 | $13.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.08 / $41.57 / $313.77
| Professional | | $22.08 | $41.57 | $313.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.39 / $34.64 / $156.85
| Professional | 26 | $18.39 | $34.64 | $156.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.09 / $5.83 / $220.13
| Professional | TC | $3.09 | $5.83 | $220.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.72 / $38.20 / $50.82
| Professional | | $21.72 | $38.20 | $50.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.16 / $28.15 / $43.36
| Professional | 26 | $18.16 | $28.15 | $43.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.68 / $5.19 / $8.36
| Professional | TC | $3.68 | $5.19 | $8.36 |