- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $71.66 / $71.66 / $178.75
| Facility | 26 | $71.66 | $71.66 | $178.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.14 / $475.00 / $856.87
| Professional | | $256.14 | $475.00 | $856.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.84 / $185.30 / $465.42
| Professional | | $71.84 | $185.30 | $465.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $271.50 / $614.35 / $908.17
| Professional | | $271.50 | $614.35 | $908.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $94.09 / $372.96
| Professional | | $32.34 | $94.09 | $372.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.38 / $634.48 / $836.23
| Professional | | $351.38 | $634.48 | $836.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.20 / $519.63 / $935.57
| Professional | | $263.20 | $519.63 | $935.57 |