- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.21 / $26.08 / $27.19
| Professional | | $23.21 | $26.08 | $27.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.01 / $5.30 / $5.91
| Professional | 26 | $4.01 | $5.30 | $5.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.50 / $20.78 / $21.65
| Professional | TC | $18.50 | $20.78 | $21.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.02 / $34.36 / $53.38
| Professional | | $30.02 | $34.36 | $53.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.83 / $6.39 / $9.35
| Professional | 26 | $5.83 | $6.39 | $9.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.19 / $24.19 / $27.68
| Professional | TC | $24.19 | $24.19 | $27.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.62 / $29.60 / $59.90
| Professional | | $19.62 | $29.60 | $59.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $3.63 / $6.46 / $10.07
| Professional | 26 | $3.63 | $6.46 | $10.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.28 / $21.99 / $50.37
| Professional | TC | $15.28 | $21.99 | $50.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.17 / $34.38 / $57.25
| Professional | | $21.17 | $34.38 | $57.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $3.89 / $7.70 / $10.17
| Professional | 26 | $3.89 | $7.70 | $10.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.54 / $24.78 / $44.21
| Professional | TC | $17.54 | $24.78 | $44.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.60 / $31.19 / $38.14
| Professional | | $21.60 | $31.19 | $38.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $4.46 / $6.38 / $8.44
| Professional | 26 | $4.46 | $6.38 | $8.44 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.23 / $24.40 / $56.68
| Professional | TC | $16.23 | $24.40 | $56.68 |