- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $25.14 / $38.09 / $41.90
| Facility | 26 | $25.14 | $38.09 | $41.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.19 / $70.65 / $78.98
| Professional | | $67.19 | $70.65 | $78.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.48 / $35.18 / $41.90
| Professional | 26 | $23.48 | $35.18 | $41.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.45 / $34.14 / $53.40
| Professional | TC | $28.45 | $34.14 | $53.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.85 / $60.85 / $60.85
| Professional | | $60.85 | $60.85 | $60.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.64 / $24.55 / $26.29
| Professional | 26 | $18.64 | $24.55 | $26.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.50 / $62.12 / $143.33
| Professional | | $45.50 | $62.12 | $143.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.86 / $36.50 / $50.95
| Professional | 26 | $27.86 | $36.50 | $50.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.64 / $22.70 / $92.37
| Professional | TC | $17.64 | $22.70 | $92.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.82 / $23.92 / $23.92
| Professional | 26 | $21.82 | $23.92 | $23.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.92 / $44.26 / $104.93
| Professional | | $26.92 | $44.26 | $104.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.29 / $26.78 / $44.18
| Professional | 26 | $16.29 | $26.78 | $44.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.50 / $17.05 / $61.33
| Professional | TC | $10.50 | $17.05 | $61.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.97 / $67.27 / $115.26
| Professional | | $44.97 | $67.27 | $115.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.04 / $27.15 / $41.73
| Professional | 26 | $21.04 | $27.15 | $41.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.07 / $39.21 / $68.40
| Professional | TC | $21.07 | $39.21 | $68.40 |