- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.55 / $34.92 / $65.28
| Facility | 26 | $26.55 | $34.92 | $65.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.19 / $61.13 / $118.31
| Professional | | $40.19 | $61.13 | $118.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.36 / $37.69 / $92.50
| Professional | 26 | $26.36 | $37.69 | $92.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.87 / $75.87 / $75.87
| Professional | | $75.87 | $75.87 | $75.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.78 / $35.25 / $47.28
| Professional | 26 | $29.78 | $35.25 | $47.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.32 / $55.38 / $85.54
| Professional | | $46.32 | $55.38 | $85.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.06 / $38.01 / $56.79
| Professional | 26 | $31.06 | $38.01 | $56.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.34 / $72.53 / $103.29
| Professional | | $45.34 | $72.53 | $103.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $28.60 / $45.70 / $66.27
| Professional | 26 | $28.60 | $45.70 | $66.27 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $70.61 / $131.69 / $131.69
| Facility | 26 | $70.61 | $131.69 | $131.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.49 / $64.06 / $358.08
| Professional | | $42.49 | $64.06 | $358.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.29 / $39.35 / $210.00
| Professional | 26 | $27.29 | $39.35 | $210.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $54.37 / $54.37 / $54.37
| Professional | 26 | $54.37 | $54.37 | $54.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.02 / $54.38 / $90.02
| Professional | | $42.02 | $54.38 | $90.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.59 / $34.44 / $56.46
| Professional | 26 | $26.59 | $34.44 | $56.46 |