- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.80 / $27.70 / $92.77
| Facility | 26 | $24.80 | $27.70 | $92.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.85 / $52.29 / $90.74
| Professional | | $29.85 | $52.29 | $90.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.55 / $24.80 / $36.86
| Professional | 26 | $19.55 | $24.80 | $36.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.31 / $27.50 / $59.46
| Professional | TC | $10.31 | $27.50 | $59.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $61.00 / $61.00 / $61.00
| Professional | | $61.00 | $61.00 | $61.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.13 / $70.90 / $87.17
| Professional | | $40.13 | $70.90 | $87.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.33 / $28.08 / $39.88
| Professional | 26 | $22.33 | $28.08 | $39.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.74 / $40.28 / $51.79
| Professional | TC | $15.74 | $40.28 | $51.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.57 / $19.57 / $20.14
| Professional | 26 | $19.57 | $19.57 | $20.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.28 / $58.92 / $103.27
| Professional | | $39.28 | $58.92 | $103.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.50 / $27.04 / $44.83
| Professional | 26 | $20.50 | $27.04 | $44.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.84 / $34.56 / $58.25
| Professional | TC | $12.84 | $34.56 | $58.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.37 / $41.59 / $69.34
| Professional | | $28.37 | $41.59 | $69.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.19 / $21.34 / $38.69
| Professional | 26 | $17.19 | $21.34 | $38.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $8.69 / $21.05 / $38.47
| Professional | TC | $8.69 | $21.05 | $38.47 |