- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.92 / $12.98 / $73.88
| Facility | 26 | $10.92 | $12.98 | $73.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.64 / $44.39 / $48.96
| Professional | | $30.64 | $44.39 | $48.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.02 / $12.68 / $13.59
| Professional | 26 | $9.02 | $12.68 | $13.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.62 / $31.57 / $35.36
| Professional | TC | $21.62 | $31.57 | $35.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.30 / $44.45 / $61.04
| Professional | | $13.30 | $44.45 | $61.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.72 / $12.72 / $20.50
| Facility | 26 | $12.72 | $12.72 | $20.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.36 / $40.88 / $64.54
| Professional | | $35.36 | $40.88 | $64.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.49 / $13.24 / $20.69
| Professional | 26 | $11.49 | $13.24 | $20.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.64 / $27.64 / $43.57
| Professional | TC | $22.64 | $27.64 | $43.57 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $31.72 / $100.00 / $100.00
| Facility | 26 | $31.72 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.77 / $52.69 / $438.00
| Professional | | $38.77 | $52.69 | $438.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.33 / $14.81 / $97.41
| Professional | 26 | $12.33 | $14.81 | $97.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.41 / $32.84 / $423.00
| Professional | TC | $25.41 | $32.84 | $423.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.93 / $44.92 / $71.48
| Professional | | $36.93 | $44.92 | $71.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.55 / $13.72 / $23.11
| Professional | 26 | $11.55 | $13.72 | $23.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.93 / $31.45 / $49.26
| Professional | TC | $24.93 | $31.45 | $49.26 |