- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $33.36 / $45.73 / $66.40
| Facility | 26 | $33.36 | $45.73 | $66.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.58 / $289.41 / $514.57
| Professional | | $258.58 | $289.41 | $514.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $312.66 / $347.40 / $399.51
| Professional | | $312.66 | $347.40 | $399.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.18 / $370.19 / $779.36
| Professional | | $225.18 | $370.19 | $779.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.56 / $367.20 / $638.60
| Professional | | $276.56 | $367.20 | $638.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.64 / $46.64 / $80.19
| Professional | 26 | $37.64 | $46.64 | $80.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $222.36 / $311.72 / $569.29
| Professional | | $222.36 | $311.72 | $569.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $232.90 / $259.73 / $412.78
| Professional | | $232.90 | $259.73 | $412.78 |