- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.66 / $14.31 / $27.58
| Facility | 26 | $11.66 | $14.31 | $27.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.78 / $42.57 / $74.89
| Professional | | $34.78 | $42.57 | $74.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.75 / $11.70 / $26.23
| Professional | 26 | $9.75 | $11.70 | $26.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.88 / $31.45 / $56.30
| Professional | TC | $24.88 | $31.45 | $56.30 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.46 / $11.46 / $11.46
| Facility | 26 | $11.46 | $11.46 | $11.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.96 / $47.56 / $78.73
| Professional | | $35.96 | $47.56 | $78.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.82 / $14.10 / $23.29
| Professional | 26 | $10.82 | $14.10 | $23.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.49 / $34.68 / $56.32
| Professional | TC | $25.49 | $34.68 | $56.32 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.86 / $13.86 / $13.86
| Facility | 26 | $13.86 | $13.86 | $13.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.44 / $54.11 / $91.01
| Professional | | $35.44 | $54.11 | $91.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.34 / $15.52 / $26.45
| Professional | 26 | $10.34 | $15.52 | $26.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.29 / $38.04 / $65.40
| Professional | TC | $25.29 | $38.04 | $65.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.22 / $45.67 / $86.68
| Professional | | $36.22 | $45.67 | $86.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.36 / $14.15 / $24.37
| Professional | 26 | $10.36 | $14.15 | $24.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.29 / $32.68 / $55.77
| Professional | TC | $25.29 | $32.68 | $55.77 |