- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.18 / $9.74 / $14.65
| Facility | 26 | $8.18 | $9.74 | $14.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.45 / $36.97 / $93.27
| Professional | | $25.45 | $36.97 | $93.27 |
- Facility/Professional
- Professional
- Modifier
- 25
- Low / Median / High Price
- $37.15 / $47.07 / $47.07
| Professional | 25 | $37.15 | $47.07 | $47.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.59 / $8.88 / $25.88
| Professional | 26 | $7.59 | $8.88 | $25.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.63 / $26.44 / $39.45
| Professional | TC | $17.63 | $26.44 | $39.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $26.83 / $36.20 / $54.90
| Professional | | $26.83 | $36.20 | $54.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.73 / $10.96 / $16.76
| Professional | 26 | $7.73 | $10.96 | $16.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.36 / $26.05 / $40.75
| Professional | TC | $18.36 | $26.05 | $40.75 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.25 / $9.25 / $9.25
| Facility | 26 | $9.25 | $9.25 | $9.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.93 / $43.50 / $72.20
| Professional | | $29.93 | $43.50 | $72.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.22 / $11.28 / $18.85
| Professional | 26 | $8.22 | $11.28 | $18.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.62 / $31.19 / $53.49
| Professional | TC | $21.62 | $31.19 | $53.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.69 / $39.54 / $68.86
| Professional | | $29.69 | $39.54 | $68.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.36 / $9.60 / $16.72
| Professional | 26 | $7.36 | $9.60 | $16.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.94 / $29.82 / $50.10
| Professional | TC | $21.94 | $29.82 | $50.10 |