- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $39.57 / $39.58 / $61.86
| Facility | 26 | $39.57 | $39.58 | $61.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $269.95 / $297.85 / $477.41
| Professional | | $269.95 | $297.85 | $477.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.05 / $421.40 / $615.44
| Professional | | $308.05 | $421.40 | $615.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $264.66 / $413.07 / $708.27
| Professional | | $264.66 | $413.07 | $708.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.79 / $524.79 / $566.05
| Professional | | $524.79 | $524.79 | $566.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.67 / $448.20 / $565.91
| Professional | | $283.67 | $448.20 | $565.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.70 / $59.57 / $73.52
| Professional | 26 | $37.70 | $59.57 | $73.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $262.73 / $492.00 / $911.47
| Professional | | $262.73 | $492.00 | $911.47 |