- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.44 / $18.71 / $26.40
| Facility | 26 | $14.44 | $18.71 | $26.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.00 / $67.11 / $104.80
| Professional | | $52.00 | $67.11 | $104.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.80 / $17.39 / $28.68
| Professional | 26 | $11.80 | $17.39 | $28.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $40.18 / $48.55 / $82.60
| Professional | TC | $40.18 | $48.55 | $82.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.15 / $40.15 / $40.15
| Professional | | $40.15 | $40.15 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.60 / $13.78 / $15.85
| Professional | 26 | $10.60 | $13.78 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.26 / $79.23 / $100.56
| Professional | | $71.26 | $79.23 | $100.56 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.02 / $21.78 / $32.70
| Professional | 26 | $17.02 | $21.78 | $32.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $54.24 / $60.21 / $79.11
| Professional | TC | $54.24 | $60.21 | $79.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.14 / $14.16 / $37.46
| Professional | 26 | $13.14 | $14.16 | $37.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.08 / $63.00 / $106.29
| Professional | | $36.08 | $63.00 | $106.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.96 / $17.19 / $31.55
| Professional | 26 | $8.96 | $17.19 | $31.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.12 / $48.94 / $81.29
| Professional | TC | $27.12 | $48.94 | $81.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $62.08 / $98.00
| Professional | | $43.41 | $62.08 | $98.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.74 / $16.93 / $27.65
| Professional | 26 | $12.74 | $16.93 | $27.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $31.62 / $44.75 / $68.06
| Professional | TC | $31.62 | $44.75 | $68.06 |