- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.84 / $8.84 / $14.27
| Facility | 26 | $8.84 | $8.84 | $14.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.35 / $31.03 / $72.06
| Professional | | $27.35 | $31.03 | $72.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.44 / $8.53 / $29.37
| Professional | 26 | $7.44 | $8.53 | $29.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.92 / $23.10 / $70.31
| Professional | TC | $19.92 | $23.10 | $70.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $63.78 / $78.70 / $82.27
| Professional | | $63.78 | $78.70 | $82.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.44 / $20.29 / $21.21
| Professional | 26 | $16.44 | $20.29 | $21.21 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $47.34 / $58.42 / $61.06
| Professional | TC | $47.34 | $58.42 | $61.06 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.61 / $9.61 / $9.61
| Facility | 26 | $9.61 | $9.61 | $9.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.02 / $54.52 / $82.29
| Professional | | $34.02 | $54.52 | $82.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.39 / $15.23 / $20.96
| Professional | 26 | $8.39 | $15.23 | $20.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.46 / $38.64 / $59.65
| Professional | TC | $24.46 | $38.64 | $59.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.26 / $59.64 / $208.83
| Professional | | $31.26 | $59.64 | $208.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.84 / $16.73 / $66.04
| Professional | 26 | $8.84 | $16.73 | $66.04 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.38 / $41.90 / $188.00
| Professional | TC | $22.38 | $41.90 | $188.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.40 / $56.66 / $77.95
| Professional | | $31.40 | $56.66 | $77.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.02 / $16.26 / $22.01
| Professional | 26 | $9.02 | $16.26 | $22.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.11 / $39.92 / $55.94
| Professional | TC | $23.11 | $39.92 | $55.94 |