- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $32.96 / $32.96 / $69.51
| Facility | 26 | $32.96 | $32.96 | $69.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.44 / $262.37 / $1,373.38
| Professional | | $163.44 | $262.37 | $1,373.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.19 / $146.41 / $255.53
| Professional | | $41.19 | $146.41 | $255.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.16 / $318.10 / $426.18
| Professional | | $256.16 | $318.10 | $426.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $67.92 / $310.73
| Professional | | $32.34 | $67.92 | $310.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $235.12 / $352.18 / $426.18
| Professional | | $235.12 | $352.18 | $426.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.50 / $202.16 / $468.70
| Professional | | $200.50 | $202.16 | $468.70 |