- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.36 / $11.70 / $14.56
| Facility | 26 | $11.36 | $11.70 | $14.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $35.72 / $63.51
| Professional | | $19.00 | $35.72 | $63.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.48 / $11.06 / $15.78
| Professional | 26 | $7.48 | $11.06 | $15.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.52 / $23.82 / $30.39
| Professional | TC | $11.52 | $23.82 | $30.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.10 / $14.20 / $15.86
| Professional | 26 | $7.10 | $14.20 | $15.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $42.84 / $47.60
| Professional | | $32.36 | $42.84 | $47.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.93 / $13.14 / $14.60
| Professional | 26 | $9.93 | $13.14 | $14.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.44 / $29.70 / $33.00
| Professional | TC | $22.44 | $29.70 | $33.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.44 / $15.02 / $27.03
| Professional | | $8.44 | $15.02 | $27.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.81 / $40.68 / $52.54
| Professional | | $26.81 | $40.68 | $52.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.30 / $12.90 / $16.89
| Professional | 26 | $8.30 | $12.90 | $16.89 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.91 / $26.41 / $36.43
| Professional | TC | $18.91 | $26.41 | $36.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.17 / $16.32 / $18.23
| Professional | 26 | $8.17 | $16.32 | $18.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.90 / $31.62 / $48.71
| Professional | | $25.90 | $31.62 | $48.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.58 / $10.11 / $17.05
| Professional | 26 | $8.58 | $10.11 | $17.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $16.32 / $20.57 / $31.91
| Professional | TC | $16.32 | $20.57 | $31.91 |