- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3.24 / $51.29 / $83.18
| Facility | | $3.24 | $51.29 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $47.86 / $57.54 / $66.07
| Facility | 26 | $47.86 | $57.54 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.98 / $46.77 / $58.88
| Professional | | $16.98 | $46.77 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.98 / $44.67 / $85.11
| Professional | 26 | $16.98 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.44 / $42.66 / $42.66
| Professional | 26 | $23.44 | $42.66 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $46.77 / $83.18
| Professional | | $24.55 | $46.77 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.33 / $22.91 / $61.66
| Professional | 26 | $9.33 | $22.91 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.14 / $10.96 / $42.66
| Facility | | $2.14 | $10.96 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.71 / $9.33 / $16.98
| Facility | 26 | $8.71 | $9.33 | $16.98 |
- 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
- $302.00 / $302.00 / $302.00
| Facility | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Facility | 26 | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $389.05 / $389.05
| Professional | | $302.00 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $281.84 / $363.08 / $363.08
| Professional | 26 | $281.84 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2.95 / $2.95 / $6.76
| Facility | | $2.95 | $2.95 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $25.12 / $50.12
| Professional | | $17.78 | $25.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.78 / $25.12 / $53.70
| Professional | 26 | $17.78 | $25.12 | $53.70 |