- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.09 / $183.35 / $215.76
| Facility | 26 | $52.09 | $183.35 | $215.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $248.09 / $423.61 / $642.33
| Professional | | $248.09 | $423.61 | $642.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $360.89 / $532.66 / $645.28
| Professional | | $360.89 | $532.66 | $645.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $436.96 / $580.49 / $942.95
| Professional | | $436.96 | $580.49 | $942.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.10 / $493.69 / $589.49
| Professional | | $395.10 | $493.69 | $589.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.00 / $124.00 / $124.00
| Professional | | $124.00 | $124.00 | $124.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $356.83 / $587.92 / $1,059.52
| Professional | | $356.83 | $587.92 | $1,059.52 |