- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $38.27 / $40.06 / $239.39
| Facility | 26 | $38.27 | $40.06 | $239.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.69 / $324.99 / $903.47
| Professional | | $275.69 | $324.99 | $903.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.66 / $379.68 / $821.24
| Professional | | $292.66 | $379.68 | $821.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $257.48 / $398.24 / $851.91
| Professional | | $257.48 | $398.24 | $851.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $263.25 / $386.83 / $938.49
| Professional | | $263.25 | $386.83 | $938.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $129.80 / $373.23 / $503.86
| Professional | | $129.80 | $373.23 | $503.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.58 / $42.63 / $57.55
| Professional | 26 | $15.58 | $42.63 | $57.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.75 / $367.03 / $700.22
| Professional | | $277.75 | $367.03 | $700.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.13 / $51.16 / $89.77
| Professional | 26 | $35.13 | $51.16 | $89.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $180.12 / $188.58
| Facility | 26 | $100.00 | $180.12 | $188.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,919.16 / $1,919.16 / $2,357.69
| Professional | | $1,919.16 | $1,919.16 | $2,357.69 |
- 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
- $260.66 / $374.95 / $936.95
| Professional | | $260.66 | $374.95 | $936.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,068.35 / $1,068.35 / $1,068.35
| Professional | | $1,068.35 | $1,068.35 | $1,068.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $194.71 / $301.89 / $415.10
| Professional | | $194.71 | $301.89 | $415.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.77 / $345.15 / $928.47
| Professional | | $226.77 | $345.15 | $928.47 |