- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.23 / $32.36 / $74.34
| Professional | | $26.23 | $32.36 | $74.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.75 / $15.86 / $22.45
| Professional | 26 | $13.75 | $15.86 | $22.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.47 / $15.59 / $51.90
| Professional | TC | $12.47 | $15.59 | $51.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.76 / $54.05 / $97.54
| Professional | | $41.76 | $54.05 | $97.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.53 / $20.74 / $37.10
| Professional | 26 | $15.53 | $20.74 | $37.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.82 / $33.90 / $63.79
| Professional | TC | $28.82 | $33.90 | $63.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.58 / $70.06 / $106.10
| Professional | | $33.58 | $70.06 | $106.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.94 / $22.86 / $32.82
| Professional | 26 | $17.94 | $22.86 | $32.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.07 / $48.38 / $73.28
| Professional | TC | $15.07 | $48.38 | $73.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.82 / $55.37 / $149.38
| Professional | | $54.82 | $55.37 | $149.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.72 / $17.89 / $31.45
| Professional | 26 | $17.72 | $17.89 | $31.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $37.10 / $42.92 / $101.10
| Professional | TC | $37.10 | $42.92 | $101.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.23 / $45.46 / $74.34
| Professional | | $26.23 | $45.46 | $74.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.75 / $17.50 / $23.55
| Professional | 26 | $13.75 | $17.50 | $23.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.43 / $27.96 / $51.90
| Professional | TC | $12.43 | $27.96 | $51.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.82 / $45.06 / $90.83
| Professional | | $34.82 | $45.06 | $90.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.33 / $21.64 / $27.73
| Professional | 26 | $15.33 | $21.64 | $27.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.77 / $22.90 / $57.73
| Professional | TC | $15.77 | $22.90 | $57.73 |