- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.48 / $162.18 / $190.55
| Facility | 26 | $52.48 | $162.18 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $112.20 / $213.80
| Professional | | $75.86 | $112.20 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.36 / $38.02 / $66.07
| Professional | 26 | $32.36 | $38.02 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.11 / $173.78 / $275.42
| Professional | | $85.11 | $173.78 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.02 / $61.66 / $97.72
| Professional | 26 | $38.02 | $61.66 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.33 / $223.87 / $446.68
| Professional | | $102.33 | $223.87 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.81 / $57.54 / $97.72
| Professional | 26 | $39.81 | $57.54 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.82 / $199.53 / $436.52
| Professional | | $128.82 | $199.53 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.90 / $54.95 / $66.07
| Professional | 26 | $38.90 | $54.95 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $147.91 / $354.81
| Professional | | $93.33 | $147.91 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.36 / $48.98 / $83.18
| Professional | 26 | $32.36 | $48.98 | $83.18 |