- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.23 / $16.98 / $45.71
| Facility | 26 | $10.23 | $16.98 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $44.67 / $125.89
| Professional | | $33.11 | $44.67 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.91 / $15.14 / $38.02
| Professional | 26 | $8.91 | $15.14 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.91 / $32.36 / $69.18
| Professional | TC | $22.91 | $32.36 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.18 / $13.18 / $13.18
| Facility | 26 | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $46.77 / $87.10
| Professional | | $33.11 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.48 / $15.85 / $26.92
| Professional | 26 | $11.48 | $15.85 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.88 / $30.90 / $61.66
| Professional | TC | $21.88 | $30.90 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $2.95 / $15.85 / $37.15
| Facility | 26 | $2.95 | $15.85 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $53.70 / $112.20
| Professional | | $33.11 | $53.70 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.00 / $16.60 / $33.11
| Professional | 26 | $10.00 | $16.60 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.91 / $38.02 / $83.18
| Professional | TC | $22.91 | $38.02 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $42.66 / $83.18
| Professional | | $32.36 | $42.66 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.23 / $13.18 / $25.12
| Professional | 26 | $10.23 | $13.18 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $30.20 / $58.88
| Professional | TC | $22.39 | $30.20 | $58.88 |