- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $17.57 / $17.57 / $23.71
| Facility | 26 | $17.57 | $17.57 | $23.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.57 / $41.16 / $60.28
| Professional | | $34.57 | $41.16 | $60.28 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.66 / $12.94 / $18.44
| Professional | 26 | $10.66 | $12.94 | $18.44 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.62 / $21.24 / $28.71
| Professional | 52 | $16.62 | $21.24 | $28.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.26 / $27.18 / $41.83
| Professional | TC | $22.26 | $27.18 | $41.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.69 / $46.37 / $46.37
| Professional | | $39.69 | $46.37 | $46.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.94 / $11.94 / $11.94
| Professional | 26 | $11.94 | $11.94 | $11.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.79 / $54.50 / $64.31
| Professional | | $39.79 | $54.50 | $64.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.43 / $22.50 / $26.55
| Professional | 26 | $16.43 | $22.50 | $26.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.36 / $32.00 / $37.76
| Professional | TC | $23.36 | $32.00 | $37.76 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.94 / $14.94 / $15.07
| Facility | 26 | $14.94 | $14.94 | $15.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.68 / $43.74 / $99.40
| Professional | | $30.68 | $43.74 | $99.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.45 / $17.80 / $36.00
| Professional | 26 | $10.45 | $17.80 | $36.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.64 / $28.52 / $64.62
| Professional | TC | $20.64 | $28.52 | $64.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.33 / $41.44 / $53.70
| Professional | | $31.33 | $41.44 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.52 / $13.42 / $18.79
| Professional | 26 | $10.52 | $13.42 | $18.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.51 / $27.46 / $36.82
| Professional | TC | $19.51 | $27.46 | $36.82 |