- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $21.38 / $94.33 / $256.76
| Facility | 26 | $21.38 | $94.33 | $256.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.03 / $43.75 / $278.70
| Professional | | $42.03 | $43.75 | $278.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.91 / $21.38 / $131.35
| Professional | 26 | $19.91 | $21.38 | $131.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.43 / $86.85 / $89.03
| Professional | | $80.43 | $86.85 | $89.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.97 / $42.10 / $43.14
| Professional | 26 | $38.97 | $42.10 | $43.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $124.20 / $124.20 / $124.20
| Facility | 26 | $124.20 | $124.20 | $124.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.38 / $104.58 / $141.00
| Professional | | $61.38 | $104.58 | $141.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.66 / $48.40 / $64.95
| Professional | 26 | $19.66 | $48.40 | $64.95 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $113.10 / $113.10 / $113.10
| Facility | 26 | $113.10 | $113.10 | $113.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.56 / $91.88 / $497.00
| Professional | | $54.56 | $91.88 | $497.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.89 / $43.70 / $320.31
| Professional | 26 | $26.89 | $43.70 | $320.31 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $92.55 / $95.24 / $124.20
| Facility | 26 | $92.55 | $95.24 | $124.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.07 / $121.65 / $157.25
| Professional | | $89.07 | $121.65 | $157.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.80 / $128.69 / $171.70
| Professional | | $122.80 | $128.69 | $171.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.56 / $88.67 / $118.84
| Professional | | $54.56 | $88.67 | $118.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.89 / $43.18 / $54.57
| Professional | 26 | $26.89 | $43.18 | $54.57 |