- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $50.12 / $154.88 / $181.97
| Facility | 26 | $50.12 | $154.88 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.80 / $323.59 / $1,071.52
| Professional | | $213.80 | $323.59 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $478.63 / $630.96
| Professional | | $302.00 | $478.63 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.03 / $436.52 / $851.14
| Professional | | $309.03 | $436.52 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $316.23 / $331.13 / $389.05
| Professional | | $316.23 | $331.13 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $53.70 / $53.70 / $56.23
| Professional | | $53.70 | $53.70 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $416.87 / $676.08
| Professional | | $234.42 | $416.87 | $676.08 |