- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $42.74 / $68.16 / $68.17
| Facility | 26 | $42.74 | $68.16 | $68.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.62 / $257.56 / $450.52
| Professional | | $229.62 | $257.56 | $450.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.75 / $39.46 / $61.61
| Professional | 26 | $36.75 | $39.46 | $61.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $192.87 / $219.46 / $388.90
| Professional | TC | $192.87 | $219.46 | $388.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $509.54 / $612.66 / $673.96
| Professional | | $509.54 | $612.66 | $673.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $76.56 / $92.06 / $100.92
| Professional | 26 | $76.56 | $92.06 | $100.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $432.98 / $520.61 / $572.69
| Professional | TC | $432.98 | $520.61 | $572.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $297.04 / $422.73 / $622.98
| Professional | | $297.04 | $422.73 | $622.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $50.22 / $74.22 / $94.64
| Professional | 26 | $50.22 | $74.22 | $94.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $231.29 / $358.38 / $532.13
| Professional | TC | $231.29 | $358.38 | $532.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.89 / $525.28 / $1,813.42
| Professional | | $288.89 | $525.28 | $1,813.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.78 / $80.59 / $328.57
| Professional | 26 | $43.78 | $80.59 | $328.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $242.24 / $440.44 / $1,562.23
| Professional | TC | $242.24 | $440.44 | $1,562.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $288.89 / $510.19 / $733.18
| Professional | | $288.89 | $510.19 | $733.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $46.66 / $76.36 / $100.60
| Professional | 26 | $46.66 | $76.36 | $100.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $242.24 / $418.42 / $603.65
| Professional | TC | $242.24 | $418.42 | $603.65 |