- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.42 / $11.02 / $115.90
| Facility | | $8.42 | $11.02 | $115.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $44.90 / $51.18 / $118.00
| Facility | 26 | $44.90 | $51.18 | $118.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $47.70 / $77.23
| Professional | | $15.66 | $47.70 | $77.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.66 / $46.48 / $71.68
| Professional | 26 | $15.66 | $46.48 | $71.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7.10 / $9.03 / $14.29
| Facility | | $7.10 | $9.03 | $14.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.49 / $50.49 / $60.59
| Professional | | $50.49 | $50.49 | $60.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $47.44 / $47.44 / $56.93
| Professional | 26 | $47.44 | $47.44 | $56.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.87 / $2.88 / $11.74
| Facility | | $1.87 | $2.88 | $11.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.45 / $43.45 / $49.82
| Professional | | $43.45 | $43.45 | $49.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.47 / $40.47 / $72.03
| Professional | 26 | $40.47 | $40.47 | $72.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.13 / $55.46 / $82.47
| Facility | | $33.13 | $55.46 | $82.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.23 / $68.73 / $169.00
| Professional | | $48.23 | $68.73 | $169.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $44.90 / $63.98 / $93.84
| Professional | 26 | $44.90 | $63.98 | $93.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.14 / $29.13 / $64.84
| Professional | | $19.14 | $29.13 | $64.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.13 / $29.68 / $64.81
| Professional | 26 | $19.13 | $29.68 | $64.81 |