- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $234.42 / $275.42 / $316.23
| Facility | 26 | $234.42 | $275.42 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,122.02 / $2,041.74
| Professional | | $831.76 | $1,122.02 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $66.07 / $309.03 / $446.68
| Facility | 26 | $66.07 | $309.03 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,348.96 / $2,290.87
| Professional | | $870.96 | $1,348.96 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $707.95 / $1,071.52
| Professional | | $676.08 | $707.95 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $398.11 / $1,230.27
| Professional | | $32.36 | $398.11 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $870.96 / $1,258.93 / $2,238.72
| Professional | | $870.96 | $1,258.93 | $2,238.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $741.31
| Professional | | $741.31 | $741.31 | $741.31 |