- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.05 / $13.69 / $16.02
| Facility | 26 | $11.05 | $13.69 | $16.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.38 / $40.70 / $66.17
| Professional | | $31.38 | $40.70 | $66.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.22 / $12.95 / $17.57
| Professional | 26 | $8.22 | $12.95 | $17.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.08 / $27.86 / $49.57
| Professional | TC | $22.08 | $27.86 | $49.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.39 / $29.39 / $29.39
| Professional | | $29.39 | $29.39 | $29.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.03 / $11.25 / $11.76
| Professional | 26 | $10.03 | $11.25 | $11.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.84 / $50.31 / $59.87
| Professional | | $44.84 | $50.31 | $59.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.64 / $15.14 / $17.77
| Professional | 26 | $12.64 | $15.14 | $17.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $31.19 / $35.75 / $46.24
| Professional | TC | $31.19 | $35.75 | $46.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.77 / $10.24 / $23.03
| Professional | 26 | $9.77 | $10.24 | $23.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.99 / $37.36 / $67.76
| Professional | | $22.99 | $37.36 | $67.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.67 / $11.01 / $20.07
| Professional | 26 | $6.67 | $11.01 | $20.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.32 / $28.71 / $47.73
| Professional | TC | $16.32 | $28.71 | $47.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.66 / $38.61 / $60.12
| Professional | | $27.66 | $38.61 | $60.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.11 / $11.88 / $17.03
| Professional | 26 | $8.11 | $11.88 | $17.03 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.89 / $26.71 / $40.72
| Professional | TC | $18.89 | $26.71 | $40.72 |