- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.63 / $10.78 / $12.43
| Facility | 26 | $8.63 | $10.78 | $12.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.51 / $41.94 / $67.84
| Professional | | $30.51 | $41.94 | $67.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.01 / $9.82 / $14.01
| Professional | 26 | $7.01 | $9.82 | $14.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.26 / $31.60 / $54.79
| Professional | TC | $22.26 | $31.60 | $54.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.65 / $29.65 / $29.65
| Professional | | $29.65 | $29.65 | $29.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.77 / $8.77 / $19.02
| Professional | 26 | $7.77 | $8.77 | $19.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.41 / $50.16 / $61.52
| Professional | | $45.41 | $50.16 | $61.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.47 / $12.10 / $16.12
| Professional | 26 | $9.47 | $12.10 | $16.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.82 / $38.82 / $46.87
| Professional | TC | $34.82 | $38.82 | $46.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.60 / $8.22 / $28.03
| Professional | 26 | $7.60 | $8.22 | $28.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.19 / $36.84 / $69.42
| Professional | | $23.19 | $36.84 | $69.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.17 / $9.50 / $15.55
| Professional | 26 | $5.17 | $9.50 | $15.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.02 / $28.80 / $52.18
| Professional | TC | $18.02 | $28.80 | $52.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.93 / $37.89 / $54.61
| Professional | | $25.93 | $37.89 | $54.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.01 / $9.43 / $14.68
| Professional | 26 | $7.01 | $9.43 | $14.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.19 / $28.80 / $42.45
| Professional | TC | $18.19 | $28.80 | $42.45 |