- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.01 / $14.02 / $15.58
| Facility | 26 | $11.01 | $14.02 | $15.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.82 / $41.70 / $69.08
| Professional | | $32.82 | $41.70 | $69.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.41 / $11.02 / $20.64
| Professional | 26 | $9.41 | $11.02 | $20.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.67 / $28.18 / $49.57
| Professional | TC | $23.67 | $28.18 | $49.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.34 / $57.47 / $82.69
| Professional | | $41.34 | $57.47 | $82.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.28 / $15.18 / $21.68
| Professional | 26 | $11.28 | $15.18 | $21.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $30.50 / $42.39 / $61.30
| Professional | TC | $30.50 | $42.39 | $61.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.35 / $48.50 / $81.58
| Professional | | $32.35 | $48.50 | $81.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.72 / $13.94 / $23.62
| Professional | 26 | $9.72 | $13.94 | $23.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.43 / $32.94 / $54.95
| Professional | TC | $22.43 | $32.94 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.45 / $73.45 / $78.38
| Professional | | $73.45 | $73.45 | $78.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.62 / $64.33 / $87.36
| Professional | | $51.62 | $64.33 | $87.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.64 / $16.98 / $23.08
| Professional | 26 | $13.64 | $16.98 | $23.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $37.99 / $47.34 / $64.28
| Professional | TC | $37.99 | $47.34 | $64.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.11 / $62.41 / $125.93
| Professional | | $38.11 | $62.41 | $125.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.87 / $19.05 / $38.47
| Professional | 26 | $10.87 | $19.05 | $38.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.05 / $43.85 / $87.45
| Professional | TC | $27.05 | $43.85 | $87.45 |