- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $18.53 / $18.54 / $25.02
| Facility | 26 | $18.53 | $18.54 | $25.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.18 / $40.06 / $58.68
| Professional | | $32.18 | $40.06 | $58.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.67 / $13.40 / $19.46
| Professional | 26 | $10.67 | $13.40 | $19.46 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.51 / $26.40 / $39.21
| Professional | TC | $21.51 | $26.40 | $39.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.18 / $32.18 / $36.52
| Professional | | $32.18 | $32.18 | $36.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.13 / $10.13 / $15.19
| Professional | 26 | $10.13 | $10.13 | $15.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.34 / $58.00 / $68.44
| Professional | | $42.34 | $58.00 | $68.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.70 / $21.50 / $25.37
| Professional | 26 | $15.70 | $21.50 | $25.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.65 / $36.50 / $43.07
| Professional | TC | $26.65 | $36.50 | $43.07 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.59 / $14.59 / $14.72
| Facility | 26 | $14.59 | $14.59 | $14.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.41 / $44.00 / $105.14
| Professional | | $30.41 | $44.00 | $105.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.15 / $17.34 / $35.00
| Professional | 26 | $11.15 | $17.34 | $35.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.47 / $31.85 / $71.12
| Professional | TC | $21.47 | $31.85 | $71.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.63 / $40.32 / $53.76
| Professional | | $31.63 | $40.32 | $53.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.37 / $14.57 / $18.19
| Professional | 26 | $11.37 | $14.57 | $18.19 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.48 / $25.79 / $36.65
| Professional | TC | $20.48 | $25.79 | $36.65 |