- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $42.96 / $48.78 / $112.87
| Facility | 26 | $42.96 | $48.78 | $112.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.06 / $120.84 / $222.89
| Professional | | $95.06 | $120.84 | $222.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.40 / $47.32 / $136.91
| Professional | 26 | $32.40 | $47.32 | $136.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.97 / $85.97 / $85.97
| Professional | | $85.97 | $85.97 | $85.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.20 / $37.61 / $68.48
| Professional | 26 | $34.20 | $37.61 | $68.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.75 / $128.80 / $207.04
| Professional | | $101.75 | $128.80 | $207.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.53 / $45.60 / $80.30
| Professional | 26 | $34.53 | $45.60 | $80.30 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $56.06 / $56.06 / $56.06
| Facility | 26 | $56.06 | $56.06 | $56.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.56 / $137.19 / $236.27
| Professional | | $79.56 | $137.19 | $236.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.47 / $50.69 / $96.75
| Professional | 26 | $32.47 | $50.69 | $96.75 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $114.26 / $217.99 / $217.99
| Facility | 26 | $114.26 | $217.99 | $217.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.65 / $143.07 / $803.00
| Professional | | $96.65 | $143.07 | $803.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.35 / $50.19 / $310.62
| Professional | 26 | $34.35 | $50.19 | $310.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.25 / $124.43 / $208.45
| Professional | | $93.25 | $124.43 | $208.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.60 / $41.89 / $77.52
| Professional | 26 | $33.60 | $41.89 | $77.52 |