- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.07 / $15.56 / $19.72
| Facility | 26 | $12.07 | $15.56 | $19.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.04 / $45.32 / $67.86
| Professional | | $33.04 | $45.32 | $67.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.83 / $14.11 / $23.23
| Professional | 26 | $9.83 | $14.11 | $23.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.07 / $31.23 / $46.62
| Professional | TC | $23.07 | $31.23 | $46.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.29 / $40.29 / $40.29
| Professional | | $40.29 | $40.29 | $40.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.43 / $22.32 / $27.47
| Professional | 26 | $9.43 | $22.32 | $27.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.75 / $55.79 / $71.65
| Professional | | $49.75 | $55.79 | $71.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.81 / $18.05 / $22.57
| Professional | 26 | $13.81 | $18.05 | $22.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.25 / $41.10 / $49.41
| Professional | TC | $34.25 | $41.10 | $49.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.98 / $11.54 / $26.11
| Professional | 26 | $10.98 | $11.54 | $26.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.51 / $41.46 / $75.73
| Professional | | $25.51 | $41.46 | $75.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.48 / $13.46 / $22.51
| Professional | 26 | $7.48 | $13.46 | $22.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.02 / $28.80 / $53.87
| Professional | TC | $18.02 | $28.80 | $53.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.69 / $42.95 / $66.23
| Professional | | $30.69 | $42.95 | $66.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.05 / $13.38 / $20.69
| Professional | 26 | $10.05 | $13.38 | $20.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.43 / $29.96 / $47.56
| Professional | TC | $20.43 | $29.96 | $47.56 |