- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.12 / $28.83 / $63.30
| Facility | 26 | $26.12 | $28.83 | $63.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.28 / $206.10 / $452.57
| Professional | | $169.28 | $206.10 | $452.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $267.00 / $267.00 / $267.00
| Professional | | $267.00 | $267.00 | $267.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.04 / $291.95 / $554.32
| Professional | | $188.04 | $291.95 | $554.32 |
- 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
- $143.25 / $246.28 / $392.93
| Professional | | $143.25 | $246.28 | $392.93 |