- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.88 / $9.69 / $59.56
| Facility | 26 | $8.88 | $9.69 | $59.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.38 / $56.44 / $91.38
| Professional | | $44.38 | $56.44 | $91.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.59 / $80.17 / $169.00
| Professional | | $56.59 | $80.17 | $169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.25 / $80.03 / $151.59
| Professional | | $56.25 | $80.03 | $151.59 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.80 / $10.80 / $10.80
| Facility | 26 | $10.80 | $10.80 | $10.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.69 / $84.61 / $169.11
| Professional | | $56.69 | $84.61 | $169.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.01 / $82.00 / $104.00
| Professional | | $63.01 | $82.00 | $104.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.40 / $31.49 / $41.60
| Professional | 26 | $10.40 | $31.49 | $41.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.02 / $57.73 / $170.00
| Professional | | $46.02 | $57.73 | $170.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.55 / $11.96 / $21.85
| Professional | 26 | $8.55 | $11.96 | $21.85 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $22.09 / $169.20 / $232.58
| Facility | 26 | $22.09 | $169.20 | $232.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $619.00 / $619.00 / $619.00
| Professional | | $619.00 | $619.00 | $619.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.52 / $32.34 / $65.51
| Professional | | $13.52 | $32.34 | $65.51 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.80 / $10.80 / $10.80
| Facility | 26 | $10.80 | $10.80 | $10.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.94 / $91.45 / $150.77
| Professional | | $57.94 | $91.45 | $150.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.00 / $177.00 / $177.00
| Professional | | $177.00 | $177.00 | $177.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.32 / $123.00 / $211.72
| Professional | | $57.32 | $123.00 | $211.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.32 / $59.38 / $128.04
| Professional | | $40.32 | $59.38 | $128.04 |