- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $31.63 / $34.85 / $83.89
| Facility | 26 | $31.63 | $34.85 | $83.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.99 / $95.90 / $123.33
| Professional | | $81.99 | $95.90 | $123.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.32 / $32.86 / $47.91
| Professional | 26 | $30.32 | $32.86 | $47.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.41 / $72.41 / $101.73
| Professional | | $72.41 | $72.41 | $101.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.12 / $36.61 / $38.20
| Professional | 26 | $27.12 | $36.61 | $38.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.34 / $123.65 / $200.93
| Professional | | $87.34 | $123.65 | $200.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.62 / $46.20 / $73.09
| Professional | 26 | $31.62 | $46.20 | $73.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $36.04 / $36.04 / $36.04
| Facility | 26 | $36.04 | $36.04 | $36.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.36 / $117.08 / $183.51
| Professional | | $87.36 | $117.08 | $183.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.36 / $42.85 / $67.20
| Professional | 26 | $32.36 | $42.85 | $67.20 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $74.91 / $140.77 / $153.47
| Facility | 26 | $74.91 | $140.77 | $153.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $560.38 / $560.38 / $745.73
| Professional | | $560.38 | $560.38 | $745.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $201.28 / $201.28 / $247.13
| Professional | 26 | $201.28 | $201.28 | $247.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.14 / $99.63 / $175.19
| Professional | | $79.14 | $99.63 | $175.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.15 / $38.82 / $69.34
| Professional | 26 | $29.15 | $38.82 | $69.34 |