- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.08 / $13.09 / $17.67
| Facility | 26 | $13.08 | $13.09 | $17.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.85 / $19.26 / $24.21
| Professional | | $13.85 | $19.26 | $24.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.82 / $9.19 / $13.74
| Professional | 26 | $7.82 | $9.19 | $13.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.03 / $9.97 / $10.84
| Professional | TC | $6.03 | $9.97 | $10.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.79 / $18.79 / $18.79
| Professional | | $18.79 | $18.79 | $18.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.35 / $7.35 / $18.07
| Professional | 26 | $7.35 | $7.35 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.36 / $32.00 / $37.76
| Professional | | $23.36 | $32.00 | $37.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.07 / $16.54 / $19.52
| Professional | 26 | $12.07 | $16.54 | $19.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.29 / $15.46 / $18.23
| Professional | TC | $11.29 | $15.46 | $18.23 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.98 / $10.98 / $11.07
| Facility | 26 | $10.98 | $10.98 | $11.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.33 / $23.74 / $45.09
| Professional | | $14.33 | $23.74 | $45.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $13.58 / $27.00
| Professional | 26 | $7.94 | $13.58 | $27.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.49 / $11.34 / $26.31
| Professional | TC | $6.49 | $11.34 | $26.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.01 / $18.52 / $33.11
| Professional | | $15.01 | $18.52 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.11 / $10.36 / $15.62
| Professional | 26 | $8.11 | $10.36 | $15.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.67 / $8.39 / $20.68
| Professional | TC | $6.67 | $8.39 | $20.68 |