- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.66 / $10.83 / $14.07
| Facility | 26 | $8.66 | $10.83 | $14.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.89 / $39.17 / $63.71
| Professional | | $29.89 | $39.17 | $63.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.01 / $9.85 / $14.67
| Professional | 26 | $7.01 | $9.85 | $14.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.57 / $28.98 / $50.73
| Professional | TC | $22.57 | $28.98 | $50.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.23 / $54.23 / $54.23
| Professional | | $54.23 | $54.23 | $54.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.81 / $8.78 / $19.05
| Professional | 26 | $7.81 | $8.78 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.82 / $47.45 / $57.01
| Professional | | $42.82 | $47.45 | $57.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.49 / $12.17 / $15.72
| Professional | 26 | $9.49 | $12.17 | $15.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $32.28 / $35.99 / $45.62
| Professional | TC | $32.28 | $35.99 | $45.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.62 / $8.24 / $20.32
| Professional | 26 | $7.62 | $8.24 | $20.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.89 / $34.81 / $65.59
| Professional | | $21.89 | $34.81 | $65.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.19 / $9.36 / $15.63
| Professional | 26 | $5.19 | $9.36 | $15.63 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.70 / $26.69 / $49.60
| Professional | TC | $16.70 | $26.69 | $49.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.31 / $36.81 / $57.55
| Professional | | $24.31 | $36.81 | $57.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.00 / $9.30 / $14.69
| Professional | 26 | $7.00 | $9.30 | $14.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.86 / $27.79 / $39.88
| Professional | TC | $16.86 | $27.79 | $39.88 |