- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $47.86 / $70.79 / $112.20
| Facility | 26 | $47.86 | $70.79 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $109.65 / $229.09
| Professional | | $87.10 | $109.65 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.11 / $50.12 / $125.89
| Professional | 26 | $33.11 | $50.12 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $85.11
| Professional | | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.31 / $38.02 / $89.13
| Professional | 26 | $36.31 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $125.89 / $190.55
| Professional | | $102.33 | $125.89 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.67 / $43.65 / $83.18
| Professional | 26 | $34.67 | $43.65 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.20 / $117.49 / $169.82
| Professional | | $112.20 | $117.49 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $45.71 / $53.70 / $67.61
| Professional | 26 | $45.71 | $53.70 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $134.90 / $245.47
| Professional | | $83.18 | $134.90 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.36 / $51.29 / $93.33
| Professional | 26 | $32.36 | $51.29 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $114.82 / $218.78 / $218.78
| Facility | 26 | $114.82 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $144.54 / $794.33
| Professional | | $89.13 | $144.54 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.88 / $52.48 / $309.03
| Professional | 26 | $33.88 | $52.48 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.10 / $120.23 / $204.17
| Professional | | $87.10 | $120.23 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.62 / $39.81 / $70.79
| Professional | 26 | $31.62 | $39.81 | $70.79 |