- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $118.27 / $263.41 / $357.62
| Facility | 26 | $118.27 | $263.41 | $357.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $260.29 / $425.00 / $605.46
| Professional | | $260.29 | $425.00 | $605.46 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $73.00 / $128.00 / $185.49
| Professional | 26 | $73.00 | $128.00 | $185.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $63.89 / $79.86 / $97.28
| Professional | 26 | $63.89 | $79.86 | $97.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $274.77 / $314.02 / $392.54
| Professional | | $274.77 | $314.02 | $392.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $73.36 / $83.84 / $104.80
| Professional | 26 | $73.36 | $83.84 | $104.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $96.46 / $96.46 / $96.46
| Facility | 26 | $96.46 | $96.46 | $96.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $227.91 / $530.20 / $845.58
| Professional | | $227.91 | $530.20 | $845.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $61.20 / $107.58 / $183.88
| Professional | 26 | $61.20 | $107.58 | $183.88 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $789.76 / $789.76 / $789.76
| Facility | 26 | $789.76 | $789.76 | $789.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.56 / $522.41 / $3,480.43
| Professional | | $270.56 | $522.41 | $3,480.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $77.61 / $91.08 / $701.72
| Professional | 26 | $77.61 | $91.08 | $701.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $270.56 / $417.49 / $681.41
| Professional | | $270.56 | $417.49 | $681.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $77.30 / $83.39 / $167.44
| Professional | 26 | $77.30 | $83.39 | $167.44 |