- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.58 / $10.81 / $14.59
| Facility | 26 | $8.58 | $10.81 | $14.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.55 / $29.20 / $42.72
| Professional | | $24.55 | $29.20 | $42.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.58 / $7.96 / $11.35
| Professional | 26 | $6.58 | $7.96 | $11.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.97 / $21.24 / $31.38
| Professional | TC | $17.97 | $21.24 | $31.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.32 / $23.83 / $33.26
| Professional | | $21.32 | $23.83 | $33.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.86 / $6.84 / $9.71
| Professional | 26 | $5.86 | $6.84 | $9.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.57 / $40.50 / $47.79
| Professional | | $29.57 | $40.50 | $47.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.77 / $13.38 / $15.79
| Professional | 26 | $9.77 | $13.38 | $15.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.80 / $27.12 / $32.00
| Professional | TC | $19.80 | $27.12 | $32.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.96 / $8.96 / $9.03
| Facility | 26 | $8.96 | $8.96 | $9.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.10 / $31.74 / $76.15
| Professional | | $22.10 | $31.74 | $76.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.46 / $10.51 / $21.00
| Professional | 26 | $6.46 | $10.51 | $21.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.53 / $23.61 / $57.04
| Professional | TC | $16.53 | $23.61 | $57.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.23 / $28.74 / $38.11
| Professional | | $22.23 | $28.74 | $38.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.50 / $8.27 / $11.12
| Professional | 26 | $6.50 | $8.27 | $11.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.04 / $20.79 / $27.72
| Professional | TC | $15.04 | $20.79 | $27.72 |