- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.51 / $7.85 / $46.99
| Facility | 26 | $7.51 | $7.85 | $46.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.70 / $29.29 / $41.61
| Professional | | $27.70 | $29.29 | $41.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.29 / $7.92 / $11.74
| Professional | 26 | $7.29 | $7.92 | $11.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.00 / $8.00 / $8.00
| Professional | 26 | $8.00 | $8.00 | $8.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.40 / $42.18 / $75.44
| Professional | | $24.40 | $42.18 | $75.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.28 / $13.51 / $21.66
| Professional | 26 | $8.28 | $13.51 | $21.66 |
- 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
- $26.70 / $39.11 / $69.95
| Professional | | $26.70 | $39.11 | $69.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.61 / $12.43 / $20.00
| Professional | 26 | $7.61 | $12.43 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.54 / $100.00 / $100.00
| Facility | 26 | $24.54 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $233.00 / $233.00 / $289.35
| Professional | | $233.00 | $233.00 | $289.35 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $97.41 / $97.41 / $97.41
| Professional | 26 | $97.41 | $97.41 | $97.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.45 / $36.29 / $62.76
| Professional | | $28.45 | $36.29 | $62.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.73 / $10.74 / $18.84
| Professional | 26 | $8.73 | $10.74 | $18.84 |