- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.85 / $10.86 / $14.66
| Facility | 26 | $10.85 | $10.86 | $14.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.12 / $28.92 / $43.65
| Professional | | $24.12 | $28.92 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.30 / $7.65 / $11.40
| Professional | 26 | $6.30 | $7.65 | $11.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.82 / $21.26 / $32.24
| Professional | TC | $17.82 | $21.26 | $32.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.10 / $25.10 / $60.66
| Professional | | $25.10 | $25.10 | $60.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.12 / $6.12 / $9.22
| Professional | 26 | $6.12 | $6.12 | $9.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.30 / $41.50 / $48.97
| Professional | | $30.30 | $41.50 | $48.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.99 / $13.69 / $16.14
| Professional | 26 | $9.99 | $13.69 | $16.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.30 / $27.81 / $32.82
| Professional | TC | $20.30 | $27.81 | $32.82 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.38 / $9.38 / $9.46
| Facility | 26 | $9.38 | $9.38 | $9.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.56 / $32.42 / $78.48
| Professional | | $22.56 | $32.42 | $78.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.49 / $10.95 / $23.00
| Professional | 26 | $6.49 | $10.95 | $23.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.27 / $24.08 / $58.74
| Professional | TC | $17.27 | $24.08 | $58.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.34 / $30.01 / $38.97
| Professional | | $22.34 | $30.01 | $38.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.77 / $8.64 / $12.10
| Professional | 26 | $6.77 | $8.64 | $12.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.61 / $21.58 / $28.15
| Professional | TC | $15.61 | $21.58 | $28.15 |