- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $21.52 / $23.71 / $57.07
| Facility | 26 | $21.52 | $23.71 | $57.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.07 / $51.57 / $95.65
| Professional | | $34.07 | $51.57 | $95.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.10 / $22.86 / $40.35
| Professional | 26 | $20.10 | $22.86 | $40.35 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.38 / $34.38 / $34.38
| Professional | 26 | $34.38 | $34.38 | $34.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.27 / $56.10 / $100.88
| Professional | | $37.27 | $56.10 | $100.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.52 / $29.71 / $45.77
| Professional | 26 | $21.52 | $29.71 | $45.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.30 / $24.30 / $24.30
| Facility | 26 | $24.30 | $24.30 | $24.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.50 / $56.53 / $100.52
| Professional | | $40.50 | $56.53 | $100.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.27 / $31.04 / $51.63
| Professional | 26 | $22.27 | $31.04 | $51.63 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $50.69 / $96.88 / $106.12
| Facility | 26 | $50.69 | $96.88 | $106.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $352.79 / $352.79 / $426.98
| Professional | | $352.79 | $352.79 | $426.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $140.68 / $140.68 / $171.23
| Professional | 26 | $140.68 | $140.68 | $171.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.56 / $49.08 / $93.03
| Professional | | $36.56 | $49.08 | $93.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.68 / $27.32 / $50.15
| Professional | 26 | $20.68 | $27.32 | $50.15 |