- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.97 / $11.74 / $15.84
| Facility | 26 | $8.97 | $11.74 | $15.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.15 / $27.50 / $41.96
| Professional | | $23.15 | $27.50 | $41.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.81 / $8.25 / $12.32
| Professional | 26 | $6.81 | $8.25 | $12.32 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.35 / $19.28 / $29.64
| Professional | TC | $16.35 | $19.28 | $29.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.49 / $21.08 / $56.48
| Professional | | $20.49 | $21.08 | $56.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.38 / $8.00 / $10.57
| Professional | 26 | $6.38 | $8.00 | $10.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.11 / $44.00 / $51.92
| Professional | | $32.11 | $44.00 | $51.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.87 / $19.00 / $22.42
| Professional | 26 | $13.87 | $19.00 | $22.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.25 / $25.00 / $29.50
| Professional | TC | $18.25 | $25.00 | $29.50 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.38 / $9.38 / $9.46
| Facility | 26 | $9.38 | $9.38 | $9.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.16 / $34.52 / $75.41
| Professional | | $24.16 | $34.52 | $75.41 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.02 / $10.63 / $24.91
| Professional | 26 | $7.02 | $10.63 | $24.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.61 / $22.42 / $54.03
| Professional | TC | $16.61 | $22.42 | $54.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.73 / $28.56 / $37.25
| Professional | | $21.73 | $28.56 | $37.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.97 / $9.00 / $11.60
| Professional | 26 | $6.97 | $9.00 | $11.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.81 / $19.48 / $25.99
| Professional | TC | $14.81 | $19.48 | $25.99 |