- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.22 / $13.64 / $40.51
| Facility | 26 | $12.22 | $13.64 | $40.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.89 / $53.10 / $88.63
| Professional | | $47.89 | $53.10 | $88.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.80 / $44.80 / $44.80
| Professional | | $44.80 | $44.80 | $44.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.87 / $52.79 / $102.33
| Professional | | $50.87 | $52.79 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.27 / $14.27 / $14.27
| Facility | 26 | $14.27 | $14.27 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.80 / $72.38 / $118.86
| Professional | | $50.80 | $72.38 | $118.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.65 / $80.16 / $105.57
| Professional | | $56.65 | $80.16 | $105.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.64 / $40.51 / $40.51
| Facility | 26 | $13.64 | $40.51 | $40.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.96 / $59.25 / $170.65
| Professional | | $47.96 | $59.25 | $170.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.82 / $59.14 / $138.30
| Professional | | $17.82 | $59.14 | $138.30 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.27 / $14.27 / $14.27
| Facility | 26 | $14.27 | $14.27 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.62 / $70.38 / $118.86
| Professional | | $50.62 | $70.38 | $118.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.27 / $12.27 / $14.00
| Facility | 26 | $12.27 | $12.27 | $14.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.50 / $50.19 / $81.00
| Professional | | $49.50 | $50.19 | $81.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.99 / $59.62 / $101.67
| Professional | | $45.99 | $59.62 | $101.67 |