- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $86.84 / $125.00 / $181.61
| Facility | 26 | $86.84 | $125.00 | $181.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $90.00 / $125.00 / $291.50
| Professional | 26 | $90.00 | $125.00 | $291.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $67.06 / $67.06 / $67.06
| Professional | 26 | $67.06 | $67.06 | $67.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $56.47 / $73.83 / $162.58
| Professional | 26 | $56.47 | $73.83 | $162.58 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $78.58 / $78.58 / $78.58
| Facility | 26 | $78.58 | $78.58 | $78.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $50.47 / $94.32 / $208.55
| Professional | 26 | $50.47 | $94.32 | $208.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $59.30 / $84.40 / $142.44
| Professional | 26 | $59.30 | $84.40 | $142.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $59.30 / $72.50 / $121.27
| Professional | 26 | $59.30 | $72.50 | $121.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $144.41 / $144.41 / $167.08
| Professional | 26 | $144.41 | $144.41 | $167.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $78.58 / $78.58 / $78.58
| Facility | 26 | $78.58 | $78.58 | $78.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $52.55 / $94.50 / $230.23
| Professional | 26 | $52.55 | $94.50 | $230.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $56.52 / $75.52 / $158.05
| Professional | 26 | $56.52 | $75.52 | $158.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $73.53 / $73.53 / $242.67
| Facility | 26 | $73.53 | $73.53 | $242.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $64.75 / $78.34 / $198.95
| Professional | 26 | $64.75 | $78.34 | $198.95 |