- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $51.56 / $56.96 / $68.34
| Facility | 26 | $51.56 | $56.96 | $68.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $80.95 / $106.69 / $157.05
| Professional | | $80.95 | $106.69 | $157.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.47 / $52.73 / $63.61
| Professional | 26 | $32.47 | $52.73 | $63.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.05 / $125.80 / $139.78
| Professional | | $95.05 | $125.80 | $139.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.49 / $57.56 / $63.95
| Professional | 26 | $43.49 | $57.56 | $63.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.59 / $136.62 / $199.91
| Professional | | $93.59 | $136.62 | $199.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.39 / $58.15 / $79.87
| Professional | 26 | $39.39 | $58.15 | $79.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.49 / $129.88 / $200.74
| Professional | | $93.49 | $129.88 | $200.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.75 / $47.21 / $78.61
| Professional | 26 | $38.75 | $47.21 | $78.61 |