- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $50.98 / $51.92 / $71.36
| Facility | 26 | $50.98 | $51.92 | $71.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.63 / $181.45 / $265.80
| Professional | | $146.63 | $181.45 | $265.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.88 / $107.88 / $107.88
| Professional | | $107.88 | $107.88 | $107.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.39 / $199.39 / $199.39
| Professional | | $199.39 | $199.39 | $199.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.35 / $201.92 / $300.92
| Professional | | $141.35 | $201.92 | $300.92 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $82.72 / $82.72 / $159.69
| Facility | 26 | $82.72 | $82.72 | $159.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $148.13 / $199.67 / $1,016.32
| Professional | | $148.13 | $199.67 | $1,016.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $141.83 / $180.19 / $282.91
| Professional | | $141.83 | $180.19 | $282.91 |