- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.72 / $106.00 / $548.35
| Facility | | $37.72 | $106.00 | $548.35 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.53 / $14.53 / $26.60
| Facility | 26 | $14.53 | $14.53 | $26.60 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $43.37 / $79.40 / $86.74
| Facility | TC | $43.37 | $79.40 | $86.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.18 / $36.18 / $49.25
| Professional | | $36.18 | $36.18 | $49.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.31 / $19.18 / $60.30
| Professional | 26 | $8.31 | $19.18 | $60.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.52 / $27.52 / $40.93
| Professional | TC | $27.52 | $27.52 | $40.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.80 / $42.80 / $76.12
| Professional | | $42.80 | $42.80 | $76.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.65 / $10.93 / $15.56
| Professional | 26 | $7.65 | $10.93 | $15.56 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.31 / $27.09 / $31.87
| Professional | TC | $22.31 | $27.09 | $31.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51.21 / $51.21 / $51.21
| Facility | | $51.21 | $51.21 | $51.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.27 / $25.86 / $75.36
| Professional | | $20.27 | $25.86 | $75.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $0.12 / $15.53 / $19.64
| Professional | 26 | $0.12 | $15.53 | $19.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $0.37 / $19.19 / $57.23
| Professional | TC | $0.37 | $19.19 | $57.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.58 / $43.67 / $69.87
| Professional | | $25.58 | $43.67 | $69.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.59 / $13.82 / $18.66
| Professional | 26 | $5.59 | $13.82 | $18.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.39 / $42.04 / $53.76
| Professional | TC | $23.39 | $42.04 | $53.76 |