- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $99.94 / $123.81 / $133.11
| Facility | 26 | $99.94 | $123.81 | $133.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.27 / $477.14 / $554.63
| Professional | | $297.27 | $477.14 | $554.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.63 / $478.63 / $531.80
| Professional | | $361.63 | $478.63 | $531.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.79 / $545.65 / $789.24
| Professional | | $320.79 | $545.65 | $789.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $351.08 / $515.87 / $679.50
| Professional | | $351.08 | $515.87 | $679.50 |