- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.84 / $52.84 / $84.46
| Facility | 26 | $52.84 | $52.84 | $84.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $293.82 / $326.70 / $505.16
| Professional | | $293.82 | $326.70 | $505.16 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.47 / $49.15 / $76.28
| Professional | 26 | $43.47 | $49.15 | $76.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $250.34 / $276.10 / $428.87
| Professional | TC | $250.34 | $276.10 | $428.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $571.95 / $687.69 / $756.49
| Professional | | $571.95 | $687.69 | $756.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $94.57 / $113.72 / $124.67
| Professional | 26 | $94.57 | $113.72 | $124.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $477.38 / $573.98 / $632.48
| Professional | TC | $477.38 | $573.98 | $632.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.41 / $572.21 / $800.16
| Professional | | $410.41 | $572.21 | $800.16 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.11 / $91.98 / $123.31
| Professional | 26 | $62.11 | $91.98 | $123.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $348.30 / $478.58 / $671.53
| Professional | TC | $348.30 | $478.58 | $671.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $376.41 / $656.69 / $2,033.50
| Professional | | $376.41 | $656.69 | $2,033.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $58.49 / $101.12 / $313.45
| Professional | 26 | $58.49 | $101.12 | $313.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $317.92 / $563.35 / $1,720.04
| Professional | TC | $317.92 | $563.35 | $1,720.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.29 / $629.50 / $862.62
| Professional | | $344.29 | $629.50 | $862.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $58.54 / $96.79 / $131.72
| Professional | 26 | $58.54 | $96.79 | $131.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $304.77 / $533.70 / $730.90
| Professional | TC | $304.77 | $533.70 | $730.90 |