- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.32 / $16.12 / $20.81
| Facility | 26 | $13.32 | $16.12 | $20.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.99 / $55.22 / $93.67
| Professional | | $42.99 | $55.22 | $93.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.75 / $15.35 / $25.50
| Professional | 26 | $10.75 | $15.35 | $25.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $32.60 / $39.10 / $68.11
| Professional | TC | $32.60 | $39.10 | $68.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.52 / $47.87 / $56.90
| Professional | | $45.52 | $47.87 | $56.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.94 / $13.32 / $13.93
| Professional | 26 | $9.94 | $13.32 | $13.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $59.11 / $65.86 / $85.07
| Professional | | $59.11 | $65.86 | $85.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.58 / $18.70 / $28.35
| Professional | 26 | $14.58 | $18.70 | $28.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $43.15 / $49.43 / $60.14
| Professional | TC | $43.15 | $49.43 | $60.14 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.58 / $12.50 / $29.83
| Professional | 26 | $11.58 | $12.50 | $29.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.27 / $50.91 / $88.12
| Professional | | $30.27 | $50.91 | $88.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.89 / $14.77 / $27.35
| Professional | 26 | $7.89 | $14.77 | $27.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.38 / $37.99 / $65.04
| Professional | TC | $22.38 | $37.99 | $65.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.42 / $50.79 / $91.66
| Professional | | $36.42 | $50.79 | $91.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.68 / $14.44 / $23.66
| Professional | 26 | $10.68 | $14.44 | $23.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.23 / $35.72 / $56.91
| Professional | TC | $25.23 | $35.72 | $56.91 |