- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $12.88 / $16.98
| Facility | 26 | $10.96 | $12.88 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.18 / $38.02 / $85.11
| Professional | | $28.18 | $38.02 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $12.02 / $25.70
| Professional | 26 | $7.94 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.62 / $25.12 / $47.86
| Professional | TC | $18.62 | $25.12 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.38 / $26.30 / $45.71
| Professional | | $21.38 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.61 / $7.59 / $15.85
| Professional | 26 | $6.61 | $7.59 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $42.66 / $52.48
| Professional | | $36.31 | $42.66 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.96 / $13.18 / $18.20
| Professional | 26 | $10.96 | $13.18 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.12 / $29.51 / $34.67
| Professional | TC | $25.12 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.77 / $24.55 / $24.55
| Professional | 26 | $9.77 | $24.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.88 / $36.31 / $70.79
| Professional | | $21.88 | $36.31 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.76 / $11.75 / $20.89
| Professional | 26 | $6.76 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.14 / $24.55 / $47.86
| Professional | TC | $15.14 | $24.55 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.70 / $34.67 / $53.70
| Professional | | $25.70 | $34.67 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.71 / $11.22 / $16.98
| Professional | 26 | $8.71 | $11.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.60 / $23.44 / $35.48
| Professional | TC | $16.60 | $23.44 | $35.48 |