- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.45 / $9.44 / $16.04
| Facility | 26 | $7.45 | $9.44 | $16.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.18 / $23.94 / $42.81
| Professional | | $20.18 | $23.94 | $42.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.63 / $7.83 / $17.16
| Professional | 26 | $6.63 | $7.83 | $17.16 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.60 / $16.76 / $30.91
| Professional | TC | $13.60 | $16.76 | $30.91 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.21 / $8.21 / $8.21
| Facility | 26 | $8.21 | $8.21 | $8.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.72 / $27.31 / $46.34
| Professional | | $21.72 | $27.31 | $46.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.44 / $10.00 / $15.51
| Professional | 26 | $7.44 | $10.00 | $15.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.36 / $18.66 / $30.94
| Professional | TC | $14.36 | $18.66 | $30.94 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.86 / $8.86 / $8.86
| Facility | 26 | $8.86 | $8.86 | $8.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.44 / $31.42 / $51.94
| Professional | | $20.44 | $31.42 | $51.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.88 / $10.59 / $17.43
| Professional | 26 | $6.88 | $10.59 | $17.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.23 / $21.17 / $35.49
| Professional | TC | $14.23 | $21.17 | $35.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.09 / $26.87 / $46.51
| Professional | | $22.09 | $26.87 | $46.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.19 / $9.32 / $16.38
| Professional | 26 | $7.19 | $9.32 | $16.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.29 / $17.86 / $32.38
| Professional | TC | $14.29 | $17.86 | $32.38 |