- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.26 / $242.50 / $526.70
| Facility | | $64.26 | $242.50 | $526.70 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.98 / $9.98 / $10.17
| Facility | 26 | $9.98 | $9.98 | $10.17 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $117.15 / $317.30 / $402.96
| Facility | TC | $117.15 | $317.30 | $402.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.37 / $27.66 / $40.11
| Professional | | $25.37 | $27.66 | $40.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.84 / $11.79 / $63.20
| Professional | 26 | $8.84 | $11.79 | $63.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.01 / $18.82 / $45.30
| Professional | TC | $17.01 | $18.82 | $45.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.00 / $142.00 / $142.00
| Professional | | $86.00 | $142.00 | $142.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.00 / $44.00 / $44.00
| Professional | 26 | $26.00 | $44.00 | $44.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $60.00 / $98.00 / $98.00
| Professional | TC | $60.00 | $98.00 | $98.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.85 / $46.59 / $79.25
| Professional | | $31.85 | $46.59 | $79.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.51 / $16.37 / $28.63
| Professional | 26 | $11.51 | $16.37 | $28.63 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.84 / $28.43 / $50.63
| Professional | TC | $19.84 | $28.43 | $50.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.27 / $64.08 / $94.60
| Professional | | $29.27 | $64.08 | $94.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.53 / $19.66 / $34.09
| Professional | 26 | $10.53 | $19.66 | $34.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.69 / $38.65 / $60.51
| Professional | TC | $18.69 | $38.65 | $60.51 |