- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.36 / $102.98 / $205.02
| Facility | 26 | $24.36 | $102.98 | $205.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $108.27 / $126.06 / $126.06
| Professional | | $108.27 | $126.06 | $126.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.36 / $140.93 / $318.60
| Professional | | $122.36 | $140.93 | $318.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.10 / $152.35 / $559.47
| Professional | | $100.10 | $152.35 | $559.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.36 / $304.72 / $304.72
| Professional | | $134.36 | $304.72 | $304.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.41 / $60.35 / $60.35
| Professional | 26 | $27.41 | $60.35 | $60.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.75 / $141.77 / $386.12
| Professional | | $87.75 | $141.77 | $386.12 |