- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $86.82 / $91.39 / $575.54
| Facility | 26 | $86.82 | $91.39 | $575.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.00 / $257.01 / $899.83
| Professional | | $220.00 | $257.01 | $899.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $325.35 / $419.64 / $844.39
| Professional | | $325.35 | $419.64 | $844.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $191.49 / $282.38 / $687.68
| Professional | | $191.49 | $282.38 | $687.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $237.28 / $333.58 / $858.80
| Professional | | $237.28 | $333.58 | $858.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $217.43 / $425.98 / $575.07
| Professional | | $217.43 | $425.98 | $575.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $80.45 / $111.77 / $150.88
| Professional | 26 | $80.45 | $111.77 | $150.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.93 / $427.85 / $749.47
| Professional | | $326.93 | $427.85 | $749.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $95.94 / $138.12 / $230.55
| Professional | 26 | $95.94 | $138.12 | $230.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $225.81 / $485.69 / $485.69
| Facility | 26 | $225.81 | $485.69 | $485.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,025.59 / $2,025.59 / $2,738.70
| Professional | | $2,025.59 | $2,025.59 | $2,738.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.95 / $348.65 / $824.40
| Professional | | $243.95 | $348.65 | $824.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $956.13 / $956.13 / $956.13
| Professional | | $956.13 | $956.13 | $956.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.66 / $358.88 / $473.72
| Professional | | $282.66 | $358.88 | $473.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.13 / $364.95 / $882.96
| Professional | | $194.13 | $364.95 | $882.96 |