- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.41 / $26.63 / $40.45
| Facility | 26 | $24.41 | $26.63 | $40.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.08 / $137.60 / $174.60
| Professional | | $120.08 | $137.60 | $174.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.97 / $24.41 / $32.20
| Professional | 26 | $21.97 | $24.41 | $32.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $128.41 / $158.07 / $247.35
| Professional | | $128.41 | $158.07 | $247.35 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.00 / $26.06 / $45.32
| Professional | 26 | $22.00 | $26.06 | $45.32 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.72 / $26.72 / $26.72
| Facility | 26 | $26.72 | $26.72 | $26.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.80 / $203.08 / $337.41
| Professional | | $144.80 | $203.08 | $337.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.21 / $32.79 / $53.69
| Professional | 26 | $23.21 | $32.79 | $53.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.06 / $192.28 / $320.32
| Professional | | $140.06 | $192.28 | $320.32 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.22 / $30.40 / $51.15
| Professional | 26 | $23.22 | $30.40 | $51.15 |