- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.36 / $10.35 / $18.14
| Facility | 26 | $8.36 | $10.35 | $18.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.92 / $30.49 / $75.17
| Professional | | $24.92 | $30.49 | $75.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.33 / $8.98 / $29.17
| Professional | 26 | $7.33 | $8.98 | $29.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.57 / $21.15 / $42.08
| Professional | TC | $17.57 | $21.15 | $42.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.93 / $8.93 / $8.93
| Facility | 26 | $8.93 | $8.93 | $8.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.93 / $34.77 / $61.44
| Professional | | $24.93 | $34.77 | $61.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.35 / $11.30 / $17.64
| Professional | 26 | $8.35 | $11.30 | $17.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.25 / $24.21 / $44.42
| Professional | TC | $16.25 | $24.21 | $44.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.01 / $10.01 / $10.01
| Facility | 26 | $10.01 | $10.01 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.38 / $37.82 / $67.92
| Professional | | $25.38 | $37.82 | $67.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.66 / $11.80 / $19.46
| Professional | 26 | $7.66 | $11.80 | $19.46 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.91 / $26.28 / $47.83
| Professional | TC | $16.91 | $26.28 | $47.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $32.71 / $58.63
| Professional | | $25.47 | $32.71 | $58.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.07 / $10.49 / $18.10
| Professional | 26 | $8.07 | $10.49 | $18.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.32 / $23.29 / $41.15
| Professional | TC | $17.32 | $23.29 | $41.15 |