- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.35 / $60.58 / $102.11
| Facility | 26 | $11.35 | $60.58 | $102.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.45 / $81.62 / $475.00
| Professional | | $44.45 | $81.62 | $475.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.35 / $12.59 / $140.00
| Professional | 26 | $11.35 | $12.59 | $140.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.46 / $22.46 / $22.46
| Professional | 26 | $22.46 | $22.46 | $22.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.87 / $86.43 / $92.01
| Professional | | $80.87 | $86.43 | $92.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.89 / $22.34 / $23.48
| Professional | 26 | $20.89 | $22.34 | $23.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $65.94 / $65.94 / $65.94
| Facility | 26 | $65.94 | $65.94 | $65.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.97 / $104.69 / $133.81
| Professional | | $51.97 | $104.69 | $133.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.77 / $26.07 / $32.97
| Professional | 26 | $14.77 | $26.07 | $32.97 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $80.00 / $80.00 / $80.00
| Facility | 26 | $80.00 | $80.00 | $80.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.73 / $98.38 / $353.51
| Professional | | $73.73 | $98.38 | $353.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.28 / $24.06 / $74.64
| Professional | 26 | $14.28 | $24.06 | $74.64 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $37.56 / $38.65 / $65.94
| Facility | 26 | $37.56 | $38.65 | $65.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.59 / $106.89 / $149.34
| Professional | | $87.59 | $106.89 | $149.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.34 / $97.27 / $122.88
| Professional | | $72.34 | $97.27 | $122.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.48 / $23.54 / $30.18
| Professional | 26 | $14.48 | $23.54 | $30.18 |