- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.00 / $10.96 / $17.78
| Facility | 26 | $10.00 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $36.31 / $91.20
| Professional | | $26.92 | $36.31 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $10.96 / $29.51
| Professional | 26 | $7.94 | $10.96 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.05 / $25.12 / $63.10
| Professional | TC | $19.05 | $25.12 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $81.28 / $89.13
| Professional | | $60.26 | $81.28 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.38 / $23.44 / $25.70
| Professional | 26 | $17.38 | $23.44 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $42.66 / $57.54 / $63.10
| Professional | TC | $42.66 | $57.54 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.90 / $52.48 / $89.13
| Professional | | $30.90 | $52.48 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.55 / $14.79 / $26.30
| Professional | 26 | $9.55 | $14.79 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.38 / $38.02 / $60.26
| Professional | TC | $21.38 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $58.88 / $223.87
| Professional | | $33.11 | $58.88 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.72 / $20.42 / $93.33
| Professional | 26 | $10.72 | $20.42 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $38.90 / $208.93
| Professional | TC | $22.39 | $38.90 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $53.70 / $83.18
| Professional | | $33.11 | $53.70 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.72 / $17.38 / $27.54
| Professional | 26 | $10.72 | $17.38 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $35.48 / $56.23
| Professional | TC | $22.39 | $35.48 | $56.23 |