- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $23.99 / $28.18 / $28.18
| Facility | 26 | $23.99 | $28.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $97.72 / $138.04
| Professional | | $43.65 | $97.72 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.99 / $56.23 / $85.11
| Professional | 26 | $23.99 | $56.23 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $114.82 / $125.89
| Professional | | $87.10 | $114.82 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $50.12 / $67.61 / $74.13
| Professional | 26 | $50.12 | $67.61 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.10 / $91.20 / $147.91
| Professional | | $63.10 | $91.20 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.15 / $51.29 / $85.11
| Professional | 26 | $37.15 | $51.29 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $85.11 / $102.33
| Professional | | $48.98 | $85.11 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.20 / $51.29 / $61.66
| Professional | 26 | $30.20 | $51.29 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $87.10 / $114.82
| Professional | | $48.98 | $87.10 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.90 / $52.48 / $70.79
| Professional | 26 | $30.90 | $52.48 | $70.79 |