- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $59.44 / $262.13 / $509.21
| Facility | 26 | $59.44 | $262.13 | $509.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $86.11 / $86.11 / $208.38
| Professional | | $86.11 | $86.11 | $208.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $59.44 / $59.44 / $143.84
| Professional | 26 | $59.44 | $59.44 | $143.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $98.01 / $101.94 / $930.77
| Professional | | $98.01 | $101.94 | $930.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $71.31 / $71.31 / $77.73
| Professional | 26 | $71.31 | $71.31 | $77.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.51 / $115.48 / $474.37
| Professional | | $83.51 | $115.48 | $474.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $52.77 / $87.96 / $292.83
| Professional | 26 | $52.77 | $87.96 | $292.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.38 / $215.91 / $215.91
| Professional | | $104.38 | $215.91 | $215.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $72.00 / $149.00 / $149.00
| Professional | 26 | $72.00 | $149.00 | $149.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.15 / $212.49 / $312.85
| Professional | | $81.15 | $212.49 | $312.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $57.02 / $76.83 / $215.89
| Professional | 26 | $57.02 | $76.83 | $215.89 |