- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $45.71 / $190.55 / $338.84
| Facility | 26 | $45.71 | $190.55 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $223.87 / $524.81
| Professional | | $181.97 | $223.87 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.43 / $79.43 / $79.43
| Professional | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $275.42 / $478.63
| Professional | | $173.78 | $275.42 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.93 / $245.47 / $416.87
| Professional | | $208.93 | $245.47 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $478.63
| Professional | | $181.97 | $275.42 | $478.63 |