- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $97.84 / $287.26 / $464.03
| Facility | 26 | $97.84 | $287.26 | $464.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.60 / $263.18 / $496.61
| Professional | | $145.60 | $263.18 | $496.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.06 / $324.33 / $370.26
| Professional | | $222.06 | $324.33 | $370.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.94 / $292.14 / $567.63
| Professional | | $236.94 | $292.14 | $567.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.07 / $237.34 / $290.32
| Professional | | $172.07 | $237.34 | $290.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.78 / $330.97 / $567.32
| Professional | | $204.78 | $330.97 | $567.32 |