- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.59 / $17.94 / $38.65
| Facility | 26 | $7.59 | $17.94 | $38.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.32 / $29.50 / $62.15
| Professional | | $23.32 | $29.50 | $62.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.08 / $8.42 / $20.86
| Professional | 26 | $7.08 | $8.42 | $20.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.53 / $30.53 / $61.86
| Professional | | $30.53 | $30.53 | $61.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.31 / $11.88 / $14.85
| Professional | 26 | $7.31 | $11.88 | $14.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.88 / $40.09 / $81.90
| Professional | | $26.88 | $40.09 | $81.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.14 / $11.82 / $23.22
| Professional | 26 | $8.14 | $11.82 | $23.22 |
- 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
- $27.64 / $47.68 / $85.38
| Professional | | $27.64 | $47.68 | $85.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.34 / $13.94 / $23.63
| Professional | 26 | $8.34 | $13.94 | $23.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.65 / $58.43 / $122.51
| Professional | | $36.65 | $58.43 | $122.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.27 / $14.80 / $31.97
| Professional | 26 | $9.27 | $14.80 | $31.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.17 / $35.01 / $56.44
| Professional | | $9.17 | $35.01 | $56.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.86 / $41.40 / $72.43
| Professional | | $27.86 | $41.40 | $72.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.27 / $11.31 / $20.00
| Professional | 26 | $8.27 | $11.31 | $20.00 |