- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.27 / $11.62 / $67.84
| Facility | 26 | $9.27 | $11.62 | $67.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.78 / $49.01 / $53.98
| Professional | | $33.78 | $49.01 | $53.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.69 / $10.81 / $11.57
| Professional | 26 | $7.69 | $10.81 | $11.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.09 / $37.95 / $42.41
| Professional | TC | $26.09 | $37.95 | $42.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.55 / $49.00 / $67.28
| Professional | | $11.55 | $49.00 | $67.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.06 / $11.06 / $17.73
| Facility | 26 | $11.06 | $11.06 | $17.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.49 / $44.97 / $69.55
| Professional | | $37.49 | $44.97 | $69.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.02 / $11.62 / $18.13
| Professional | 26 | $10.02 | $11.62 | $18.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.66 / $33.40 / $52.29
| Professional | TC | $26.66 | $33.40 | $52.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.96 / $100.00 / $100.00
| Facility | 26 | $26.96 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.82 / $56.17 / $345.31
| Professional | | $42.82 | $56.17 | $345.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.99 / $12.88 / $142.00
| Professional | 26 | $10.99 | $12.88 | $142.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.67 / $38.51 / $272.83
| Professional | TC | $30.67 | $38.51 | $272.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.71 / $48.94 / $78.94
| Professional | | $41.71 | $48.94 | $78.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.74 / $12.00 / $18.95
| Professional | 26 | $10.74 | $12.00 | $18.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.14 / $37.00 / $59.55
| Professional | TC | $30.14 | $37.00 | $59.55 |