- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.49 / $15.90 / $27.43
| Facility | 26 | $13.49 | $15.90 | $27.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.14 / $33.96 / $71.70
| Professional | | $17.14 | $33.96 | $71.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.32 / $14.44 / $37.38
| Professional | 26 | $7.32 | $14.44 | $37.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.11 / $21.64 / $47.04
| Professional | TC | $10.11 | $21.64 | $47.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.57 / $8.57 / $8.57
| Facility | 26 | $8.57 | $8.57 | $8.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.32 / $29.08 / $64.33
| Professional | | $19.32 | $29.08 | $64.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.60 / $11.39 / $23.98
| Professional | 26 | $8.60 | $11.39 | $23.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.81 / $17.46 / $40.96
| Professional | TC | $10.81 | $17.46 | $40.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $17.32 / $17.32 / $17.32
| Facility | 26 | $17.32 | $17.32 | $17.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.01 / $35.42 / $79.93
| Professional | | $20.01 | $35.42 | $79.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.58 / $13.45 / $30.96
| Professional | 26 | $8.58 | $13.45 | $30.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.08 / $21.86 / $52.71
| Professional | TC | $11.08 | $21.86 | $52.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.37 / $41.49 / $78.61
| Professional | | $19.37 | $41.49 | $78.61 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.83 / $16.02 / $29.76
| Professional | 26 | $7.83 | $16.02 | $29.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.21 / $26.41 / $49.69
| Professional | TC | $11.21 | $26.41 | $49.69 |