- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.21 / $134.22 / $154.65
| Professional | | $91.21 | $134.22 | $154.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.67 / $27.89 / $32.47
| Professional | 26 | $21.67 | $27.89 | $32.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.56 / $161.72 / $214.15
| Professional | | $106.56 | $161.72 | $214.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.44 / $39.29 / $57.85
| Professional | 26 | $29.44 | $39.29 | $57.85 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $159.84 / $242.59 / $321.23
| Professional | 50 | $159.84 | $242.59 | $321.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.15 / $196.26 / $333.45
| Professional | | $138.15 | $196.26 | $333.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.13 / $43.50 / $64.56
| Professional | 26 | $26.13 | $43.50 | $64.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $187.81 / $187.81 / $187.81
| Professional | 50 | $187.81 | $187.81 | $187.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.13 / $160.22 / $289.02
| Professional | | $133.13 | $160.22 | $289.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.51 / $45.13 / $81.43
| Professional | 26 | $37.51 | $45.13 | $81.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.53 / $137.44 / $178.43
| Professional | | $119.53 | $137.44 | $178.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.03 / $28.79 / $46.15
| Professional | 26 | $25.03 | $28.79 | $46.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.58 / $163.15 / $321.94
| Professional | | $138.58 | $163.15 | $321.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.59 / $41.72 / $67.62
| Professional | 26 | $29.59 | $41.72 | $67.62 |