- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.02 / $19.50 / $50.12
| Facility | 26 | $12.02 | $19.50 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $46.77 / $128.82
| Professional | | $33.11 | $46.77 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $16.98 / $43.65
| Professional | 26 | $10.96 | $16.98 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.88 / $30.20 / $67.61
| Professional | TC | $21.88 | $30.20 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.45 / $14.45 / $14.45
| Facility | 26 | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $48.98 / $91.20
| Professional | | $36.31 | $48.98 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.75 / $17.78 / $30.20
| Professional | 26 | $11.75 | $17.78 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.12 / $33.11 / $61.66
| Professional | TC | $25.12 | $33.11 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $3.39 / $17.78 / $43.65
| Facility | 26 | $3.39 | $17.78 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $56.23 / $114.82
| Professional | | $33.88 | $56.23 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.22 / $18.62 / $37.15
| Professional | 26 | $11.22 | $18.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.91 / $38.90 / $79.43
| Professional | TC | $22.91 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.88 / $44.67 / $85.11
| Professional | | $33.88 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.22 / $15.14 / $28.84
| Professional | 26 | $11.22 | $15.14 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $29.51 / $56.23
| Professional | TC | $22.39 | $29.51 | $56.23 |