- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.88 / $18.20 / $54.95
| Facility | | $12.88 | $18.20 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.02 / $13.18 / $14.13
| Facility | 26 | $12.02 | $13.18 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.02 / $33.88 / $56.23
| Professional | | $12.02 | $33.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.88 / $32.36 / $52.48
| Professional | 26 | $12.88 | $32.36 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.99 / $23.99 / $39.81
| Professional | 26 | $23.99 | $23.99 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $0.02 / $0.03
| Facility | | $0.02 | $0.02 | $0.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $45.71
| Professional | | $44.67 | $44.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $41.69 / $41.69 / $42.66
| Professional | 26 | $41.69 | $41.69 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44.67 / $44.67 / $44.67
| Facility | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.81 / $39.81 / $39.81
| Professional | 26 | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.47 / $23.99 / $52.48
| Facility | | $3.47 | $23.99 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $43.65 / $43.65
| Professional | | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Professional | 26 | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.95 / $2.95 / $16.98
| Facility | | $1.95 | $2.95 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.38 / $20.89 / $41.69
| Professional | | $17.38 | $20.89 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.38 / $20.89 / $37.15
| Professional | 26 | $17.38 | $20.89 | $37.15 |