- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.69 / $65.69 / $108.09
| Facility | | $45.69 | $65.69 | $108.09 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $19.64 / $61.96 / $101.94
| Facility | 26 | $19.64 | $61.96 | $101.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.66 / $50.39 / $56.26
| Professional | | $15.66 | $50.39 | $56.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.66 / $46.20 / $52.93
| Professional | 26 | $15.66 | $46.20 | $52.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.28 / $50.46 / $64.61
| Professional | | $42.28 | $50.46 | $64.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.48 / $19.14 / $48.37
| Professional | 26 | $7.48 | $19.14 | $48.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.46 / $7.66 / $41.58
| Facility | | $5.46 | $7.66 | $41.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.45 / $43.45 / $45.02
| Professional | | $43.45 | $43.45 | $45.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.47 / $40.47 / $41.96
| Professional | 26 | $40.47 | $40.47 | $41.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26.39 / $52.43 / $242.00
| Facility | | $26.39 | $52.43 | $242.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $87.68 / $223.26 / $223.26
| Facility | 26 | $87.68 | $223.26 | $223.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.07 / $27.37 / $302.45
| Professional | | $18.07 | $27.37 | $302.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.86 / $27.36 / $283.52
| Professional | 26 | $17.86 | $27.36 | $283.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.87 / $26.01 / $57.25
| Professional | | $17.87 | $26.01 | $57.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.57 / $26.54 / $59.74
| Professional | 26 | $16.57 | $26.54 | $59.74 |