- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $68.76 / $72.53 / $411.90
| Facility | 26 | $68.76 | $72.53 | $411.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $242.58 / $336.44 / $1,601.19
| Professional | | $242.58 | $336.44 | $1,601.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.01 / $468.92 / $901.57
| Professional | | $310.01 | $468.92 | $901.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $236.40 / $363.49 / $875.67
| Professional | | $236.40 | $363.49 | $875.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $254.58 / $412.26 / $865.86
| Professional | | $254.58 | $412.26 | $865.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $250.82 / $342.66 / $462.59
| Professional | | $250.82 | $342.66 | $462.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $57.69 / $75.86 / $102.41
| Professional | 26 | $57.69 | $75.86 | $102.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.07 / $342.66 / $573.48
| Professional | | $258.07 | $342.66 | $573.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.29 / $90.65 / $159.02
| Professional | 26 | $62.29 | $90.65 | $159.02 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $162.19 / $319.44 / $334.21
| Facility | 26 | $162.19 | $319.44 | $334.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,216.00 / $2,279.71 / $2,279.71
| Professional | | $2,216.00 | $2,279.71 | $2,279.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $32.34
| Professional | | $32.34 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.81 / $401.42 / $864.12
| Professional | | $251.81 | $401.42 | $864.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $980.04 / $980.04 / $980.04
| Professional | | $980.04 | $980.04 | $980.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $277.14 / $381.06 / $611.62
| Professional | | $277.14 | $381.06 | $611.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.39 / $321.16 / $903.73
| Professional | | $253.39 | $321.16 | $903.73 |