- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $19.97 / $19.97 / $103.37
| Facility | 26 | $19.97 | $19.97 | $103.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.14 / $57.74 / $78.59
| Professional | | $46.14 | $57.74 | $78.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.45 / $80.45 / $133.78
| Professional | | $45.45 | $80.45 | $133.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.73 / $82.13 / $140.88
| Professional | | $67.73 | $82.13 | $140.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.98 / $56.59 / $100.45
| Professional | | $40.98 | $56.59 | $100.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.67 / $63.64 / $112.92
| Professional | | $45.67 | $63.64 | $112.92 |