- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.19 / $14.11 / $17.98
| Facility | 26 | $8.19 | $14.11 | $17.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.00 / $33.14 / $45.79
| Professional | | $19.00 | $33.14 | $45.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.48 / $8.81 / $17.98
| Professional | 26 | $7.48 | $8.81 | $17.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $113.57 / $113.57 / $113.57
| Professional | 50 | $113.57 | $113.57 | $113.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.52 / $21.80 / $26.53
| Professional | TC | $11.52 | $21.80 | $26.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.51 / $19.00 / $47.38
| Professional | | $17.51 | $19.00 | $47.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.36 / $9.27 / $19.88
| Professional | 26 | $6.36 | $9.27 | $19.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.00 / $44.00 / $44.00
| Professional | | $44.00 | $44.00 | $44.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.64 / $39.25 / $59.00
| Professional | | $19.64 | $39.25 | $59.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.40 / $13.34 / $18.38
| Professional | 26 | $7.40 | $13.34 | $18.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.24 / $26.69 / $39.08
| Professional | TC | $12.24 | $26.69 | $39.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.25 / $32.34 / $32.34
| Professional | | $7.25 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.65 / $30.13 / $53.97
| Professional | | $22.65 | $30.13 | $53.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.50 / $10.55 / $18.26
| Professional | 26 | $7.50 | $10.55 | $18.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.02 / $19.42 / $35.85
| Professional | TC | $15.02 | $19.42 | $35.85 |