- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.71 / $13.83 / $17.48
| Facility | 26 | $10.71 | $13.83 | $17.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.74 / $40.01 / $67.15
| Professional | | $31.74 | $40.01 | $67.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.99 / $12.56 / $21.18
| Professional | 26 | $8.99 | $12.56 | $21.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.03 / $27.69 / $47.26
| Professional | TC | $23.03 | $27.69 | $47.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.14 / $28.14 / $28.14
| Professional | | $28.14 | $28.14 | $28.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.71 / $9.71 / $16.27
| Professional | 26 | $9.71 | $9.71 | $16.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.95 / $48.21 / $65.04
| Professional | | $42.95 | $48.21 | $65.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.24 / $15.70 / $22.57
| Professional | 26 | $12.24 | $15.70 | $22.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.72 / $35.11 / $47.50
| Professional | TC | $30.72 | $35.11 | $47.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.47 / $10.22 / $24.33
| Professional | 26 | $9.47 | $10.22 | $24.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.02 / $39.04 / $66.23
| Professional | | $22.02 | $39.04 | $66.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.46 / $12.26 / $21.78
| Professional | 26 | $6.46 | $12.26 | $21.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.56 / $28.08 / $46.30
| Professional | TC | $15.56 | $28.08 | $46.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.67 / $37.59 / $71.98
| Professional | | $27.67 | $37.59 | $71.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.59 / $12.07 / $19.39
| Professional | 26 | $9.59 | $12.07 | $19.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.72 / $25.93 / $43.01
| Professional | TC | $18.72 | $25.93 | $43.01 |