- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $30.44 / $32.78 / $185.16
| Facility | 26 | $30.44 | $32.78 | $185.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.48 / $91.25 / $115.31
| Professional | | $74.48 | $91.25 | $115.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.45 / $90.43 / $133.61
| Professional | | $37.45 | $90.43 | $133.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.31 / $92.48 / $138.19
| Professional | | $78.31 | $92.48 | $138.19 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $89.32 / $169.56 / $169.56
| Facility | 26 | $89.32 | $169.56 | $169.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $87.60 / $114.08 / $767.00
| Professional | | $87.60 | $114.08 | $767.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.82 / $95.66 / $142.99
| Professional | | $82.82 | $95.66 | $142.99 |