- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $86.19 / $98.25 / $132.85
| Facility | 26 | $86.19 | $98.25 | $132.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.69 / $277.33 / $414.96
| Professional | | $253.69 | $277.33 | $414.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $81.27 / $90.18 / $150.83
| Professional | 26 | $81.27 | $90.18 | $150.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.62 / $80.61 / $117.92
| Professional | 26 | $62.62 | $80.61 | $117.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.12 / $343.90 / $515.85
| Professional | | $275.12 | $343.90 | $515.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $72.87 / $78.90 / $122.29
| Professional | 26 | $72.87 | $78.90 | $122.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.52 / $222.48 / $367.86
| Professional | | $83.52 | $222.48 | $367.86 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $96.97 / $96.97 / $96.97
| Facility | 26 | $96.97 | $96.97 | $96.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.58 / $470.19 / $839.65
| Professional | | $292.58 | $470.19 | $839.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $80.16 / $108.42 / $188.15
| Professional | 26 | $80.16 | $108.42 | $188.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.12 / $400.16 / $669.74
| Professional | | $290.12 | $400.16 | $669.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $77.92 / $94.32 / $178.19
| Professional | 26 | $77.92 | $94.32 | $178.19 |