- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.71 / $15.85 / $42.66
| Facility | 26 | $8.71 | $15.85 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.13 / $20.89 / $61.66
| Professional | | $14.13 | $20.89 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $10.96 / $37.15
| Professional | 26 | $7.94 | $10.96 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.03 / $8.91 / $20.89
| Professional | TC | $6.03 | $8.91 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.02 / $12.02 / $12.02
| Facility | 26 | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.78 / $26.30 / $52.48
| Professional | | $17.78 | $26.30 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.77 / $13.18 / $22.91
| Professional | 26 | $9.77 | $13.18 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $8.32 / $12.59 / $30.90
| Professional | TC | $8.32 | $12.59 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $2.45 / $13.18 / $30.90
| Facility | 26 | $2.45 | $13.18 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.22 / $28.84 / $54.95
| Professional | | $16.22 | $28.84 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.32 / $14.13 / $27.54
| Professional | 26 | $8.32 | $14.13 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.41 / $14.45 / $28.84
| Professional | TC | $7.41 | $14.45 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.60 / $23.44 / $42.66
| Professional | | $16.60 | $23.44 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.51 / $11.22 / $21.38
| Professional | 26 | $8.51 | $11.22 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $7.59 / $10.96 / $22.39
| Professional | TC | $7.59 | $10.96 | $22.39 |