- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $54.48 / $154.41 / $400.44
| Facility | 26 | $54.48 | $154.41 | $400.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $132.18 / $149.93 / $349.33
| Professional | | $132.18 | $149.93 | $349.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.36 / $149.43 / $316.05
| Professional | | $120.36 | $149.43 | $316.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.15 / $179.30 / $460.33
| Professional | | $123.15 | $179.30 | $460.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $203.87 / $407.94 / $407.94
| Professional | | $203.87 | $407.94 | $407.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $67.39 / $137.78 / $137.78
| Professional | 26 | $67.39 | $137.78 | $137.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.61 / $137.03 / $561.54
| Professional | | $105.61 | $137.03 | $561.54 |