- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $81.01 / $180.44 / $244.96
| Facility | 26 | $81.01 | $180.44 | $244.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $197.25 / $289.64 / $401.36
| Professional | | $197.25 | $289.64 | $401.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $51.30 / $58.18 / $77.26
| Professional | 26 | $51.30 | $58.18 | $77.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $185.18 / $196.43 / $196.43
| Professional | | $185.18 | $196.43 | $196.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.93 / $76.17 / $76.17
| Professional | 26 | $43.93 | $76.17 | $76.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $241.71 / $276.24 / $345.30
| Professional | | $241.71 | $276.24 | $345.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.71 / $56.81 / $71.01
| Professional | 26 | $49.71 | $56.81 | $71.01 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $65.64 / $65.64 / $65.64
| Facility | 26 | $65.64 | $65.64 | $65.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.19 / $364.41 / $600.67
| Professional | | $208.19 | $364.41 | $600.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $41.89 / $69.31 / $123.66
| Professional | 26 | $41.89 | $69.31 | $123.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $537.20 / $537.20 / $537.20
| Facility | 26 | $537.20 | $537.20 | $537.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $239.89 / $344.65 / $2,077.23
| Professional | | $239.89 | $344.65 | $2,077.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.28 / $58.27 / $394.61
| Professional | 26 | $49.28 | $58.27 | $394.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.69 / $326.92 / $604.15
| Professional | | $237.69 | $326.92 | $604.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.28 / $53.08 / $109.90
| Professional | 26 | $49.28 | $53.08 | $109.90 |