- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.96 / $52.96 / $84.74
| Facility | 26 | $52.96 | $52.96 | $84.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.63 / $239.18 / $555.12
| Professional | | $229.63 | $239.18 | $555.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.44 / $53.46 / $107.29
| Professional | 26 | $49.44 | $53.46 | $107.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.95 / $90.40 / $131.75
| Professional | 26 | $49.95 | $90.40 | $131.75 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $60.41 / $60.41 / $60.41
| Facility | 26 | $60.41 | $60.41 | $60.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.56 / $354.68 / $631.97
| Professional | | $226.56 | $354.68 | $631.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $52.76 / $83.63 / $155.44
| Professional | 26 | $52.76 | $83.63 | $155.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $51.18 / $70.93 / $144.74
| Facility | 26 | $51.18 | $70.93 | $144.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $213.00 / $349.00
| Professional | | $70.00 | $213.00 | $349.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $65.59 / $65.59 / $194.89
| Professional | 26 | $65.59 | $65.59 | $194.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.14 / $317.18 / $481.94
| Professional | | $82.14 | $317.18 | $481.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.14 / $251.01 / $606.34
| Professional | | $124.14 | $251.01 | $606.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.02 / $56.19 / $138.51
| Professional | 26 | $31.02 | $56.19 | $138.51 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $122.35 / $268.99 / $268.99
| Facility | 26 | $122.35 | $268.99 | $268.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,659.46 / $2,730.98 / $2,730.98
| Professional | | $1,659.46 | $2,730.98 | $2,730.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $337.70 / $432.90 / $432.90
| Professional | 26 | $337.70 | $432.90 | $432.90 |