- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.16 / $7.86 / $17.25
| Facility | 26 | $7.16 | $7.86 | $17.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.51 / $37.53 / $76.70
| Professional | | $30.51 | $37.53 | $76.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.86 / $9.78 / $17.25
| Professional | 26 | $7.86 | $9.78 | $17.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.26 / $27.74 / $59.46
| Professional | TC | $22.26 | $27.74 | $59.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.03 / $77.69 / $77.69
| Professional | | $27.03 | $77.69 | $77.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.10 / $7.63 / $19.07
| Professional | 26 | $6.10 | $7.63 | $19.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.34 / $28.34 / $28.34
| Professional | TC | $28.34 | $28.34 | $28.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.00 / $48.00 / $48.00
| Professional | | $48.00 | $48.00 | $48.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.76 / $44.09 / $66.27
| Professional | | $29.76 | $44.09 | $66.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.84 / $13.31 / $18.98
| Professional | 26 | $6.84 | $13.31 | $18.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.32 / $32.29 / $48.53
| Professional | TC | $22.32 | $32.29 | $48.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.87 / $32.34 / $32.34
| Professional | | $6.87 | $32.34 | $32.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.13 / $39.34 / $58.73
| Professional | | $27.13 | $39.34 | $58.73 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.30 / $9.92 / $18.10
| Professional | 26 | $7.30 | $9.92 | $18.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.53 / $30.99 / $51.54
| Professional | TC | $18.53 | $30.99 | $51.54 |