- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $15.64 / $19.55 / $25.38
| Facility | 26 | $15.64 | $19.55 | $25.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.14 / $46.25 / $71.70
| Professional | | $17.14 | $46.25 | $71.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.03 / $17.76 / $23.29
| Professional | 26 | $7.03 | $17.76 | $23.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.11 / $28.49 / $48.42
| Professional | TC | $10.11 | $28.49 | $48.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.02 / $16.55 / $31.00
| Professional | 26 | $8.02 | $16.55 | $31.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.40 / $52.46 / $62.17
| Professional | | $28.40 | $52.46 | $62.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.90 / $19.55 / $24.57
| Professional | 26 | $12.90 | $19.55 | $24.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.91 / $31.09 / $38.99
| Professional | TC | $13.91 | $31.09 | $38.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.74 / $14.50 / $15.79
| Professional | 26 | $13.74 | $14.50 | $15.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.31 / $35.13 / $70.25
| Professional | | $21.31 | $35.13 | $70.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.68 / $13.45 / $27.82
| Professional | 26 | $8.68 | $13.45 | $27.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.25 / $22.17 / $42.43
| Professional | TC | $12.25 | $22.17 | $42.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.34 / $37.99 / $55.87
| Professional | | $16.34 | $37.99 | $55.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.90 / $14.62 / $21.46
| Professional | 26 | $6.90 | $14.62 | $21.46 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $9.44 / $24.24 / $35.65
| Professional | TC | $9.44 | $24.24 | $35.65 |