- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $12.02 / $58.88
| Facility | 26 | $10.96 | $12.02 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.54 / $47.86 / $85.11
| Professional | | $27.54 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $13.18 / $32.36
| Professional | 26 | $10.96 | $13.18 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.91 / $34.67 / $52.48
| Professional | TC | $22.91 | $34.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $32.36 / $53.70
| Professional | | $25.12 | $32.36 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.55 / $12.30 / $20.42
| Professional | 26 | $9.55 | $12.30 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.89 / $26.92 / $41.69
| Professional | TC | $20.89 | $26.92 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.84 / $51.29 / $74.13
| Professional | | $28.84 | $51.29 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.23 / $19.05 / $26.92
| Professional | 26 | $10.23 | $19.05 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.50 / $33.11 / $48.98
| Professional | TC | $19.50 | $33.11 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $32.36 / $33.11
| Professional | | $21.88 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $41.69 / $75.86
| Professional | | $30.20 | $41.69 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $14.13 / $27.54
| Professional | 26 | $10.96 | $14.13 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.05 / $27.54 / $46.77
| Professional | TC | $19.05 | $27.54 | $46.77 |