- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.08 / $30.09 / $69.06
| Professional | | $24.08 | $30.09 | $69.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.23 / $23.01 / $34.36
| Professional | 26 | $17.23 | $23.01 | $34.36 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $12.04 / $13.80 / $34.54
| Professional | 52 | $12.04 | $13.80 | $34.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.70 / $4.62 / $51.14
| Professional | TC | $2.70 | $4.62 | $51.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.44 / $41.98 / $60.28
| Professional | | $24.44 | $41.98 | $60.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.38 / $26.13 / $48.90
| Professional | 26 | $18.38 | $26.13 | $48.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.99 / $4.75 / $38.22
| Professional | TC | $2.99 | $4.75 | $38.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.74 / $33.34 / $42.25
| Professional | | $32.74 | $33.34 | $42.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.83 / $28.20 / $36.07
| Professional | 26 | $27.83 | $28.20 | $36.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $4.79 / $5.13 / $6.32
| Professional | TC | $4.79 | $5.13 | $6.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.43 / $26.91 / $27.71
| Professional | | $5.43 | $26.91 | $27.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.46 / $22.87 / $23.51
| Professional | 26 | $19.46 | $22.87 | $23.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $3.42 / $4.01 / $4.90
| Professional | TC | $3.42 | $4.01 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.50 / $27.97 / $50.58
| Professional | | $18.50 | $27.97 | $50.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.37 / $19.72 / $34.17
| Professional | 26 | $13.37 | $19.72 | $34.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2.49 / $4.11 / $32.21
| Professional | TC | $2.49 | $4.11 | $32.21 |