- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.68 / $11.69 / $15.78
| Facility | 26 | $11.68 | $11.69 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.48 / $27.41 / $33.65
| Professional | | $17.48 | $27.41 | $33.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.79 / $8.19 / $12.27
| Professional | 26 | $6.79 | $8.19 | $12.27 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.70 / $18.68 / $22.17
| Professional | TC | $10.70 | $18.68 | $22.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.79 / $24.72 / $24.72
| Professional | | $15.79 | $24.72 | $24.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.35 / $6.45 / $9.53
| Professional | 26 | $6.35 | $6.45 | $9.53 |
- 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
- $9.61 / $13.16 / $15.53
| Professional | 26 | $9.61 | $13.16 | $15.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.69 / $28.34 / $33.44
| Professional | TC | $20.69 | $28.34 | $33.44 |
- 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
- $18.96 / $31.43 / $59.42
| Professional | | $18.96 | $31.43 | $59.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.99 / $11.75 / $23.00
| Professional | 26 | $6.99 | $11.75 | $23.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.95 / $22.57 / $39.51
| Professional | TC | $11.95 | $22.57 | $39.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.11 / $25.70 / $38.40
| Professional | | $21.11 | $25.70 | $38.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.04 / $8.96 / $11.60
| Professional | 26 | $7.04 | $8.96 | $11.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.07 / $17.82 / $25.92
| Professional | TC | $14.07 | $17.82 | $25.92 |