- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $74.13 / $263.03 / $302.00
| Facility | 26 | $74.13 | $263.03 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.18 / $100.00 / $269.15
| Professional | | $83.18 | $100.00 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.44 / $120.23 / $190.55
| Professional | | $72.44 | $120.23 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $104.71 / $154.88 / $288.40
| Professional | | $104.71 | $154.88 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.72 / $141.25 / $194.98
| Professional | | $97.72 | $141.25 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $93.33 / $95.50
| Professional | | $89.13 | $93.33 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.13 / $131.83 / $245.47
| Professional | | $89.13 | $131.83 | $245.47 |