- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $35.04 / $40.38 / $148.94
| Facility | 26 | $35.04 | $40.38 | $148.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.83 / $80.70 / $112.04
| Professional | | $53.83 | $80.70 | $112.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.78 / $41.28 / $57.23
| Professional | 26 | $33.78 | $41.28 | $57.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $81.41 / $88.06 / $198.30
| Facility | 26 | $81.41 | $88.06 | $198.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.53 / $129.26 / $717.71
| Professional | | $62.53 | $129.26 | $717.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.06 / $58.42 / $305.45
| Professional | 26 | $36.06 | $58.42 | $305.45 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $44.07 / $44.07 / $120.60
| Professional | 50 | $44.07 | $44.07 | $120.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.63 / $122.63 / $216.67
| Professional | | $70.63 | $122.63 | $216.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $42.97 / $67.39 / $109.15
| Professional | 26 | $42.97 | $67.39 | $109.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.83 / $53.78 / $106.87
| Professional | | $28.83 | $53.78 | $106.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $69.22 / $135.53 / $183.99
| Professional | | $69.22 | $135.53 | $183.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.01 / $84.21 / $112.48
| Professional | 26 | $43.01 | $84.21 | $112.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $81.41 / $198.30 / $198.30
| Facility | 26 | $81.41 | $198.30 | $198.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.84 / $130.16 / $717.71
| Professional | | $65.84 | $130.16 | $717.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.04 / $59.39 / $305.45
| Professional | 26 | $37.04 | $59.39 | $305.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $64.52 / $100.21 / $199.70
| Professional | | $64.52 | $100.21 | $199.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.04 / $48.71 / $103.50
| Professional | 26 | $37.04 | $48.71 | $103.50 |