- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.60 / $30.32 / $39.43
| Facility | 26 | $24.60 | $30.32 | $39.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.88 / $57.10 / $95.04
| Professional | | $39.88 | $57.10 | $95.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.92 / $27.48 / $36.36
| Professional | 26 | $16.92 | $27.48 | $36.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.50 / $26.52 / $64.31
| Professional | TC | $20.50 | $26.52 | $64.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.27 / $47.70 / $73.87
| Professional | | $41.27 | $47.70 | $73.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.94 / $24.61 / $43.45
| Professional | 26 | $21.94 | $24.61 | $43.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.19 / $66.37 / $96.99
| Professional | | $52.19 | $66.37 | $96.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.15 / $30.24 / $40.85
| Professional | 26 | $23.15 | $30.24 | $40.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.62 / $32.84 / $70.66
| Professional | TC | $26.62 | $32.84 | $70.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.39 / $23.53 / $35.61
| Professional | 26 | $21.39 | $23.53 | $35.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.77 / $50.53 / $112.38
| Professional | | $29.77 | $50.53 | $112.38 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.59 / $23.53 / $43.15
| Professional | 26 | $14.59 | $23.53 | $43.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.18 / $24.66 / $88.12
| Professional | TC | $15.18 | $24.66 | $88.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.08 / $54.38 / $108.76
| Professional | | $37.08 | $54.38 | $108.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.67 / $24.91 / $37.36
| Professional | 26 | $16.67 | $24.91 | $37.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.62 / $25.67 / $66.95
| Professional | TC | $18.62 | $25.67 | $66.95 |