- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $81.42 / $90.61 / $269.11
| Facility | 26 | $81.42 | $90.61 | $269.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $130.29 / $147.32 / $183.56
| Professional | | $130.29 | $147.32 | $183.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.49 / $217.25 / $277.38
| Professional | | $144.49 | $217.25 | $277.38 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $97.96 / $97.96 / $97.96
| Facility | 26 | $97.96 | $97.96 | $97.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.65 / $192.80 / $335.76
| Professional | | $139.65 | $192.80 | $335.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.33 / $219.05 / $294.39
| Professional | | $149.33 | $219.05 | $294.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.78 / $179.78 / $179.78
| Professional | | $179.78 | $179.78 | $179.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $90.61 / $90.61 / $269.11
| Facility | 26 | $90.61 | $90.61 | $269.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.84 / $154.80 / $273.39
| Professional | | $140.84 | $154.80 | $273.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.00 / $122.37 / $264.63
| Professional | | $68.00 | $122.37 | $264.63 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $97.96 / $97.96 / $97.96
| Facility | 26 | $97.96 | $97.96 | $97.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.65 / $192.80 / $338.98
| Professional | | $139.65 | $192.80 | $338.98 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $78.95 / $84.78 / $84.78
| Facility | 26 | $78.95 | $84.78 | $84.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.49 / $147.04 / $156.69
| Professional | | $144.49 | $147.04 | $156.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.79 / $166.04 / $283.11
| Professional | | $131.79 | $166.04 | $283.11 |