- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.98 / $10.22 / $14.57
| Facility | 26 | $8.98 | $10.22 | $14.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.92 / $30.60 / $45.79
| Professional | | $19.92 | $30.60 | $45.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.29 / $10.22 / $16.12
| Professional | 26 | $7.29 | $10.22 | $16.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.62 / $20.46 / $27.80
| Professional | TC | $12.62 | $20.46 | $27.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.11 / $9.46 / $16.07
| Professional | 26 | $9.11 | $9.46 | $16.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.50 / $32.61 / $53.03
| Professional | | $27.50 | $32.61 | $53.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.24 / $13.08 / $16.29
| Professional | 26 | $10.24 | $13.08 | $16.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.27 / $19.71 / $40.54
| Professional | TC | $17.27 | $19.71 | $40.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.91 / $8.82 / $13.26
| Professional | 26 | $7.91 | $8.82 | $13.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $14.12 / $26.45 / $48.39
| Professional | | $14.12 | $26.45 | $48.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.38 / $9.89 / $16.19
| Professional | 26 | $5.38 | $9.89 | $16.19 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $41.47 / $41.47 / $41.47
| Professional | 50 | $41.47 | $41.47 | $41.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $8.74 / $16.77 / $32.69
| Professional | TC | $8.74 | $16.77 | $32.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.07 / $28.76 / $46.71
| Professional | | $22.07 | $28.76 | $46.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.25 / $9.77 / $14.68
| Professional | 26 | $7.25 | $9.77 | $14.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.82 / $19.14 / $33.29
| Professional | TC | $14.82 | $19.14 | $33.29 |