- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $49.78 / $55.58 / $61.66
| Facility | 26 | $49.78 | $55.58 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.81 / $92.82 / $144.93
| Professional | | $80.81 | $92.82 | $144.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.47 / $85.47 / $85.47
| Professional | | $85.47 | $85.47 | $85.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.73 / $131.69 / $177.08
| Professional | | $86.73 | $131.69 | $177.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $59.27 / $59.27 / $59.27
| Facility | 26 | $59.27 | $59.27 | $59.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.01 / $113.94 / $201.43
| Professional | | $80.01 | $113.94 | $201.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.69 / $131.58 / $176.95
| Professional | | $89.69 | $131.58 | $176.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.71 / $103.70 / $131.03
| Professional | | $99.71 | $103.70 | $131.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $49.78 / $61.13 / $165.07
| Facility | 26 | $49.78 | $61.13 | $165.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $84.46 / $102.43 / $261.11
| Professional | | $84.46 | $102.43 | $261.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.38 / $82.74 / $159.22
| Professional | | $41.38 | $82.74 | $159.22 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $59.27 / $59.27 / $59.27
| Facility | 26 | $59.27 | $59.27 | $59.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.01 / $113.94 / $204.86
| Professional | | $80.01 | $113.94 | $204.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $46.86 / $50.92 / $50.92
| Facility | 26 | $46.86 | $50.92 | $50.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.27 / $86.64 / $92.37
| Professional | | $85.27 | $86.64 | $92.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.02 / $108.05 / $185.00
| Professional | | $82.02 | $108.05 | $185.00 |