- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.82 / $10.52 / $58.69
| Facility | 26 | $9.82 | $10.52 | $58.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.55 / $39.33 / $42.57
| Professional | | $26.55 | $39.33 | $42.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.13 / $10.44 / $12.24
| Professional | 26 | $8.13 | $10.44 | $12.24 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.43 / $27.64 / $31.92
| Professional | TC | $18.43 | $27.64 | $31.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.85 / $41.85 / $41.85
| Professional | | $41.85 | $41.85 | $41.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.99 / $8.99 / $19.09
| Professional | 26 | $8.99 | $8.99 | $19.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.25 / $38.50 / $52.87
| Professional | | $12.25 | $38.50 | $52.87 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.74 / $9.74 / $15.55
| Facility | 26 | $9.74 | $9.74 | $15.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.01 / $35.65 / $59.60
| Professional | | $32.01 | $35.65 | $59.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.32 / $10.78 / $17.50
| Professional | 26 | $9.32 | $10.78 | $17.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.06 / $24.88 / $43.29
| Professional | TC | $22.06 | $24.88 | $43.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $28.48 / $100.00 / $100.00
| Facility | 26 | $28.48 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.97 / $46.12 / $271.52
| Professional | | $34.97 | $46.12 | $271.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.85 / $12.48 / $97.41
| Professional | 26 | $9.85 | $12.48 | $97.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.86 / $29.21 / $210.00
| Professional | TC | $22.86 | $29.21 | $210.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.90 / $38.95 / $63.05
| Professional | | $32.90 | $38.95 | $63.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.85 / $11.69 / $19.48
| Professional | 26 | $9.85 | $11.69 | $19.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.52 / $27.73 / $45.04
| Professional | TC | $22.52 | $27.73 | $45.04 |