- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $39.81 / $47.86 / $69.18
| Facility | 26 | $39.81 | $47.86 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.54 / $87.10 / $186.21
| Professional | | $57.54 | $87.10 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Professional | 50 | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.49 / $158.49 / $173.78
| Professional | | $117.49 | $158.49 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $234.42 / $316.23 / $346.74
| Professional | 50 | $234.42 | $316.23 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $91.20 / $128.82 / $251.19
| Professional | | $91.20 | $128.82 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $239.88 / $891.25
| Professional | | $97.72 | $239.88 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $93.33 / $169.82 / $309.03
| Professional | | $93.33 | $169.82 | $309.03 |