- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $46.68 / $69.79 / $185.97
| Facility | 26 | $46.68 | $69.79 | $185.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.25 / $134.94 / $520.04
| Professional | | $94.25 | $134.94 | $520.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.20 / $103.61 / $106.13
| Professional | | $74.20 | $103.61 | $106.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.05 / $129.38 / $292.75
| Professional | | $102.05 | $129.38 | $292.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.98 / $90.61 / $172.60
| Professional | | $81.98 | $90.61 | $172.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $64.00 / $64.00 / $64.00
| Facility | 26 | $64.00 | $64.00 | $64.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.02 / $179.69 / $373.72
| Professional | | $100.02 | $179.69 | $373.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $114.97 / $152.01 / $233.29
| Professional | | $114.97 | $152.01 | $233.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.63 / $146.21 / $245.49
| Professional | | $94.63 | $146.21 | $245.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $121.35 / $137.85 / $209.23
| Professional | | $121.35 | $137.85 | $209.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.04 / $136.66 / $239.11
| Professional | | $135.04 | $136.66 | $239.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $64.00 / $64.00 / $64.00
| Facility | 26 | $64.00 | $64.00 | $64.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $111.66 / $169.12 / $372.34
| Professional | | $111.66 | $169.12 | $372.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.15 / $119.44 / $281.77
| Professional | | $95.15 | $119.44 | $281.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $65.61 / $65.61 / $160.00
| Facility | 26 | $65.61 | $65.61 | $160.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.90 / $155.66 / $304.39
| Professional | | $116.90 | $155.66 | $304.39 |