- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.33 / $13.48 / $15.44
| Facility | 26 | $7.33 | $13.48 | $15.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.84 / $29.62 / $71.31
| Professional | | $22.84 | $29.62 | $71.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.33 / $9.07 / $20.59
| Professional | 26 | $7.33 | $9.07 | $20.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.52 / $19.57 / $42.43
| Professional | TC | $15.52 | $19.57 | $42.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.76 / $21.75 / $38.99
| Professional | | $6.76 | $21.75 | $38.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.22 / $38.26 / $52.09
| Professional | | $27.22 | $38.26 | $52.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.24 / $12.75 / $20.37
| Professional | 26 | $8.24 | $12.75 | $20.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.05 / $25.65 / $31.79
| Professional | TC | $18.05 | $25.65 | $31.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $11.57 / $32.34 / $37.65
| Professional | | $11.57 | $32.34 | $37.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.97 / $45.67 / $70.27
| Professional | | $28.97 | $45.67 | $70.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.25 / $12.93 / $17.86
| Professional | 26 | $8.25 | $12.93 | $17.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.88 / $25.52 / $31.71
| Professional | TC | $17.88 | $25.52 | $31.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.12 / $25.20 / $68.40
| Professional | | $21.12 | $25.20 | $68.40 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.48 / $9.42 / $28.58
| Professional | 26 | $7.48 | $9.42 | $28.58 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.89 / $17.42 / $43.62
| Professional | TC | $13.89 | $17.42 | $43.62 |