- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $21.73 / $31.48 / $55.87
| Facility | 26 | $21.73 | $31.48 | $55.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.47 / $43.92 / $70.65
| Professional | | $33.47 | $43.92 | $70.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.06 / $23.48 / $24.25
| Professional | 26 | $21.06 | $23.48 | $24.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.42 / $23.50 / $47.17
| Professional | TC | $12.42 | $23.50 | $47.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.70 / $83.27 / $109.47
| Professional | | $32.70 | $83.27 | $109.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.88 / $28.13 / $42.31
| Professional | 26 | $18.88 | $28.13 | $42.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.81 / $56.69 / $71.59
| Professional | TC | $13.81 | $56.69 | $71.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $24.46 / $28.50 / $52.65
| Professional | 26 | $24.46 | $28.50 | $52.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.42 / $82.65 / $108.09
| Professional | | $39.42 | $82.65 | $108.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.05 / $30.30 / $53.67
| Professional | 26 | $19.05 | $30.30 | $53.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.09 / $52.60 / $74.48
| Professional | TC | $20.09 | $52.60 | $74.48 |