- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $37.15 / $37.15 / $69.12
| Facility | 26 | $37.15 | $37.15 | $69.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.10 / $69.26 / $161.66
| Professional | | $57.10 | $69.26 | $161.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.63 / $40.28 / $105.00
| Professional | 26 | $32.63 | $40.28 | $105.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $37.42 / $83.74 / $173.80
| Facility | 26 | $37.42 | $83.74 | $173.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.49 / $102.39 / $457.11
| Professional | | $62.49 | $102.39 | $457.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.38 / $52.39 / $229.85
| Professional | 26 | $34.38 | $52.39 | $229.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.26 / $59.41 / $124.96
| Professional | 26 | $34.26 | $59.41 | $124.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $40.09 / $40.09 / $40.09
| Facility | 26 | $40.09 | $40.09 | $40.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.51 / $118.93 / $254.23
| Professional | | $73.51 | $118.93 | $254.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.47 / $64.06 / $123.29
| Professional | 26 | $39.47 | $64.06 | $123.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.23 / $46.16 / $100.25
| Professional | | $22.23 | $46.16 | $100.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.69 / $145.44 / $214.45
| Professional | | $76.69 | $145.44 | $214.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.56 / $75.40 / $107.12
| Professional | 26 | $36.56 | $75.40 | $107.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.64 / $110.64 / $110.64
| Professional | | $110.64 | $110.64 | $110.64 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $83.11 / $173.80 / $173.80
| Facility | 26 | $83.11 | $173.80 | $173.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.52 / $109.19 / $457.11
| Professional | | $72.52 | $109.19 | $457.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $41.38 / $63.85 / $229.85
| Professional | 26 | $41.38 | $63.85 | $229.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.52 / $95.34 / $210.86
| Professional | | $72.52 | $95.34 | $210.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $41.38 / $54.27 / $117.46
| Professional | 26 | $41.38 | $54.27 | $117.46 |