- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.46 / $12.64 / $30.04
| Facility | 26 | $8.46 | $12.64 | $30.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.69 / $32.15 / $58.19
| Professional | | $26.69 | $32.15 | $58.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.40 / $8.46 / $15.41
| Professional | 26 | $7.40 | $8.46 | $15.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.53 / $30.53 / $30.53
| Professional | | $30.53 | $30.53 | $30.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.51 / $11.51 / $13.99
| Professional | 26 | $11.51 | $11.51 | $13.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.40 / $31.33 / $52.54
| Professional | | $23.40 | $31.33 | $52.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.48 / $10.80 / $18.95
| Professional | 26 | $9.48 | $10.80 | $18.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.03 / $25.00 / $34.04
| Professional | | $9.03 | $25.00 | $34.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.01 / $10.01 / $10.74
| Facility | 26 | $10.01 | $10.01 | $10.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.64 / $40.98 / $74.15
| Professional | | $27.64 | $40.98 | $74.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.65 / $11.62 / $19.60
| Professional | 26 | $7.65 | $11.62 | $19.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.01 / $10.01 / $10.74
| Facility | 26 | $10.01 | $10.01 | $10.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.65 / $40.42 / $68.91
| Professional | | $27.65 | $40.42 | $68.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.31 / $11.67 / $19.32
| Professional | 26 | $8.31 | $11.67 | $19.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.52 / $36.24 / $51.07
| Professional | | $26.52 | $36.24 | $51.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.01 / $33.92 / $63.34
| Professional | | $24.01 | $33.92 | $63.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.04 / $10.38 / $17.98
| Professional | 26 | $7.04 | $10.38 | $17.98 |