- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.50 / $12.02 / $14.04
| Facility | 26 | $7.50 | $12.02 | $14.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.92 / $27.71 / $52.78
| Professional | | $24.92 | $27.71 | $52.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.33 / $7.88 / $19.87
| Professional | 26 | $7.33 | $7.88 | $19.87 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.57 / $19.62 / $34.10
| Professional | TC | $17.57 | $19.62 | $34.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.37 / $21.37 / $23.42
| Professional | | $21.37 | $21.37 | $23.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.42 / $8.83 / $14.81
| Professional | 26 | $6.42 | $8.83 | $14.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.35 / $38.46 / $67.64
| Professional | | $22.35 | $38.46 | $67.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.77 / $12.95 / $20.62
| Professional | 26 | $7.77 | $12.95 | $20.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.48 / $26.53 / $47.53
| Professional | TC | $16.48 | $26.53 | $47.53 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.92 / $9.92 / $10.01
| Facility | 26 | $9.92 | $9.92 | $10.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.16 / $35.54 / $65.40
| Professional | | $24.16 | $35.54 | $65.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.45 / $11.84 / $19.73
| Professional | 26 | $7.45 | $11.84 | $19.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.47 / $24.78 / $45.83
| Professional | TC | $16.47 | $24.78 | $45.83 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.27 / $202.27 / $263.85
| Professional | | $202.27 | $202.27 | $263.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $111.75 / $111.75 / $111.75
| Professional | 26 | $111.75 | $111.75 | $111.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $146.99 / $146.99 / $193.58
| Professional | TC | $146.99 | $146.99 | $193.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.47 / $32.63 / $59.44
| Professional | | $25.47 | $32.63 | $59.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.28 / $10.74 / $18.07
| Professional | 26 | $8.28 | $10.74 | $18.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.32 / $23.14 / $40.85
| Professional | TC | $17.32 | $23.14 | $40.85 |