- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $32.29 / $35.89 / $46.41
| Facility | 26 | $32.29 | $35.89 | $46.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.54 / $69.09 / $116.20
| Professional | | $48.54 | $69.09 | $116.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.97 / $34.15 / $53.14
| Professional | 26 | $22.97 | $34.15 | $53.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.55 / $33.21 / $85.82
| Professional | TC | $25.55 | $33.21 | $85.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.10 / $54.23 / $56.55
| Professional | | $46.10 | $54.23 | $56.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.26 / $26.23 / $62.61
| Professional | 26 | $22.26 | $26.23 | $62.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.73 / $74.58 / $126.53
| Professional | | $66.73 | $74.58 | $126.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.77 / $35.29 / $52.85
| Professional | 26 | $31.77 | $35.29 | $52.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $33.01 / $38.84 / $94.35
| Professional | TC | $33.01 | $38.84 | $94.35 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.06 / $26.00 / $28.45
| Professional | 26 | $25.06 | $26.00 | $28.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.06 / $60.52 / $129.71
| Professional | | $36.06 | $60.52 | $129.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.09 / $29.78 / $51.40
| Professional | 26 | $17.09 | $29.78 | $51.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.91 / $30.57 / $69.03
| Professional | TC | $18.91 | $30.57 | $69.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.93 / $66.88 / $125.08
| Professional | | $44.93 | $66.88 | $125.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.74 / $29.59 / $44.48
| Professional | 26 | $21.74 | $29.59 | $44.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.82 / $32.14 / $80.15
| Professional | TC | $22.82 | $32.14 | $80.15 |