- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.94 / $51.23 / $83.90
| Facility | | $47.94 | $51.23 | $83.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $45.23 / $49.22 / $65.58
| Facility | 26 | $45.23 | $49.22 | $65.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.43 / $47.94 / $53.52
| Professional | | $32.43 | $47.94 | $53.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.23 / $45.23 / $49.97
| Professional | 26 | $17.23 | $45.23 | $49.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.74 / $42.43 / $42.43
| Professional | 26 | $32.74 | $42.43 | $42.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.95 / $69.37 / $110.66
| Professional | | $43.95 | $69.37 | $110.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.98 / $29.12 / $71.61
| Professional | 26 | $17.98 | $29.12 | $71.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5.77 / $12.32 / $42.35
| Facility | | $5.77 | $12.32 | $42.35 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.67 / $9.27 / $52.60
| Facility | 26 | $8.67 | $9.27 | $52.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.45 / $43.45 / $43.45
| Professional | | $43.45 | $43.45 | $43.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.47 / $40.47 / $40.47
| Professional | 26 | $40.47 | $40.47 | $40.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.00 / $242.00 / $244.58
| Facility | | $85.00 | $242.00 | $244.58 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $85.00 / $223.26 / $227.00
| Facility | 26 | $85.00 | $223.26 | $227.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.45 / $302.45 / $392.55
| Professional | | $302.45 | $302.45 | $392.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $283.52 / $283.52 / $363.08
| Professional | 26 | $283.52 | $283.52 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.87 / $26.74 / $74.73
| Professional | | $17.87 | $26.74 | $74.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.96 / $27.38 / $116.54
| Professional | 26 | $17.96 | $27.38 | $116.54 |