- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $64.89 / $64.89 / $178.75
| Facility | 26 | $64.89 | $64.89 | $178.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.84 / $475.00 / $1,025.99
| Professional | | $358.84 | $475.00 | $1,025.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $57.00 / $140.00 / $167.79
| Professional | 26 | $57.00 | $140.00 | $167.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $65.11 / $288.23 / $725.28
| Professional | | $65.11 | $288.23 | $725.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.99 / $618.53 / $740.69
| Professional | | $358.99 | $618.53 | $740.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.55 / $112.82 / $139.08
| Professional | 26 | $62.55 | $112.82 | $139.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $329.39 / $605.38
| Professional | | $32.34 | $329.39 | $605.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.49 / $622.04 / $740.69
| Professional | | $363.49 | $622.04 | $740.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.77 / $112.82 / $139.08
| Professional | 26 | $62.77 | $112.82 | $139.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.71 / $401.85 / $921.90
| Professional | | $344.71 | $401.85 | $921.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $61.85 / $65.92 / $167.68
| Professional | 26 | $61.85 | $65.92 | $167.68 |