- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.08 / $8.09 / $44.35
| Facility | 26 | $7.08 | $8.09 | $44.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.49 / $30.33 / $32.83
| Professional | | $20.49 | $30.33 | $32.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.90 / $8.16 / $8.88
| Professional | 26 | $5.90 | $8.16 | $8.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.59 / $22.18 / $23.95
| Professional | TC | $14.59 | $22.18 | $23.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.75 / $29.75 / $40.85
| Professional | | $8.75 | $29.75 | $40.85 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.79 / $7.79 / $12.79
| Facility | 26 | $7.79 | $7.79 | $12.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.85 / $27.08 / $42.29
| Professional | | $22.85 | $27.08 | $42.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.98 / $7.95 / $12.56
| Professional | 26 | $6.98 | $7.95 | $12.56 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.07 / $19.13 / $30.52
| Professional | TC | $15.07 | $19.13 | $30.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $20.47 / $100.00 / $100.00
| Facility | 26 | $20.47 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.32 / $32.64 / $208.77
| Professional | | $25.32 | $32.64 | $208.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.39 / $9.06 / $82.56
| Professional | 26 | $7.39 | $9.06 | $82.56 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.62 / $21.60 / $153.47
| Professional | TC | $17.62 | $21.60 | $153.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.43 / $29.83 / $51.81
| Professional | | $24.43 | $29.83 | $51.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.36 / $8.34 / $13.86
| Professional | 26 | $7.36 | $8.34 | $13.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.05 / $20.47 / $34.11
| Professional | TC | $17.05 | $20.47 | $34.11 |