- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $118.01 / $123.18 / $150.79
| Facility | 26 | $118.01 | $123.18 | $150.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.33 / $177.00 / $223.76
| Professional | | $126.33 | $177.00 | $223.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $245.14 / $245.14 / $245.20
| Professional | | $245.14 | $245.14 | $245.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.81 / $216.01 / $228.72
| Professional | | $172.81 | $216.01 | $228.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.66 / $100.79 / $195.48
| Professional | | $79.66 | $100.79 | $195.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.44 / $222.39 / $301.22
| Professional | | $150.44 | $222.39 | $301.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.88 / $194.88 / $301.89
| Professional | | $139.88 | $194.88 | $301.89 |