- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.24 / $29.61 / $37.01
| Facility | 26 | $12.24 | $29.61 | $37.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.77 / $33.40 / $59.93
| Professional | | $23.77 | $33.40 | $59.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.77 / $8.82 / $17.73
| Professional | 26 | $6.77 | $8.82 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.26 / $22.26 / $30.53
| Professional | | $22.26 | $22.26 | $30.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.85 / $11.85 / $11.85
| Professional | 26 | $11.85 | $11.85 | $11.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.21 / $29.95 / $37.44
| Professional | | $26.21 | $29.95 | $37.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.04 / $6.90 / $8.63
| Professional | 26 | $6.04 | $6.90 | $8.63 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.01 / $10.01 / $10.01
| Facility | 26 | $10.01 | $10.01 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.62 / $37.45 / $63.11
| Professional | | $27.62 | $37.45 | $63.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.37 / $10.72 / $18.64
| Professional | 26 | $7.37 | $10.72 | $18.64 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.86 / $33.92 / $233.00
| Professional | | $28.86 | $33.92 | $233.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.51 / $9.38 / $97.41
| Professional | 26 | $8.51 | $9.38 | $97.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.08 / $33.92 / $62.20
| Professional | | $28.08 | $33.92 | $62.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.41 / $9.38 / $16.55
| Professional | 26 | $8.41 | $9.38 | $16.55 |