- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.76 / $11.75 / $15.14
| Facility | 26 | $7.76 | $11.75 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $32.36 / $75.86
| Professional | | $25.12 | $32.36 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.08 / $8.91 / $22.39
| Professional | 26 | $7.08 | $8.91 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.78 / $22.91 / $44.67
| Professional | TC | $17.78 | $22.91 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.50 / $24.55 / $48.98
| Professional | | $19.50 | $24.55 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.37 / $6.17 / $7.76
| Professional | 26 | $5.37 | $6.17 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.78 / $19.50 / $43.65
| Professional | TC | $17.78 | $19.50 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $32.36 / $54.95
| Professional | | $28.84 | $32.36 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.71 / $11.48 / $17.78
| Professional | 26 | $8.71 | $11.48 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.95 / $20.89 / $38.90
| Professional | TC | $19.95 | $20.89 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $40.74 / $69.18
| Professional | | $25.70 | $40.74 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.24 / $11.22 / $18.20
| Professional | 26 | $7.24 | $11.22 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.50 / $29.51 / $52.48
| Professional | TC | $19.50 | $29.51 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $32.36 / $53.70
| Professional | | $26.92 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.59 / $9.12 / $15.14
| Professional | 26 | $7.59 | $9.12 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.62 / $22.91 / $38.02
| Professional | TC | $18.62 | $22.91 | $38.02 |