- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $65.27 / $207.59 / $257.02
| Facility | 26 | $65.27 | $207.59 | $257.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.86 / $136.03 / $596.00
| Professional | | $110.86 | $136.03 | $596.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $151.52 / $216.02 / $277.27
| Professional | | $151.52 | $216.02 | $277.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.94 / $228.49 / $386.29
| Professional | | $131.94 | $228.49 | $386.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.97 / $152.49 / $202.31
| Professional | | $129.97 | $152.49 | $202.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.70 / $87.18 / $166.33
| Professional | | $85.70 | $87.18 | $166.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.90 / $194.32 / $346.74
| Professional | | $119.90 | $194.32 | $346.74 |