- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $18.20 / $25.12 / $52.48
| Facility | 26 | $18.20 | $25.12 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.07 / $95.50 / $144.54
| Professional | | $66.07 | $95.50 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $87.10 / $177.83
| Professional | | $36.31 | $87.10 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $4.68 / $25.12 / $67.61
| Facility | 26 | $4.68 | $25.12 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $117.49 / $275.42
| Professional | | $41.69 | $117.49 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.66 / $97.72 / $199.53
| Professional | | $42.66 | $97.72 | $199.53 |