- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $29.98 / $89.38 / $108.84
| Facility | 26 | $29.98 | $89.38 | $108.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.77 / $49.84 / $88.15
| Professional | | $33.77 | $49.84 | $88.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.66 / $20.27 / $32.81
| Professional | 26 | $16.66 | $20.27 | $32.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.17 / $30.22 / $52.28
| Professional | TC | $15.17 | $30.22 | $52.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.69 / $59.53 / $120.17
| Professional | | $39.69 | $59.53 | $120.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.60 / $33.54 / $43.59
| Professional | 26 | $16.60 | $33.54 | $43.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.10 / $28.96 / $67.25
| Professional | TC | $17.10 | $28.96 | $67.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.96 / $61.97 / $147.44
| Professional | | $50.96 | $61.97 | $147.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.92 / $34.74 / $58.39
| Professional | 26 | $22.92 | $34.74 | $58.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.95 / $33.82 / $96.57
| Professional | TC | $21.95 | $33.82 | $96.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.48 / $72.90 / $134.66
| Professional | | $57.48 | $72.90 | $134.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.94 / $31.93 / $46.25
| Professional | 26 | $22.94 | $31.93 | $46.25 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.15 / $47.72 / $88.41
| Professional | TC | $25.15 | $47.72 | $88.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $42.69 / $60.94 / $126.20
| Professional | | $42.69 | $60.94 | $126.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.14 / $27.30 / $49.82
| Professional | 26 | $18.14 | $27.30 | $49.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.64 / $34.56 / $78.77
| Professional | TC | $21.64 | $34.56 | $78.77 |