- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $5.31 / $5.55 / $6.76
| Facility | 26 | $5.31 | $5.55 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.96 / $24.81 / $31.94
| Professional | | $13.96 | $24.81 | $31.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.75 / $5.31 / $6.98
| Professional | 26 | $2.75 | $5.31 | $6.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $11.16 / $19.69 / $24.95
| Professional | TC | $11.16 | $19.69 | $24.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.04 / $23.04 / $23.04
| Professional | | $23.04 | $23.04 | $23.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.20 / $2.20 / $3.08
| Professional | 26 | $2.20 | $2.20 | $3.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.48 / $19.52 / $40.32
| Professional | | $15.48 | $19.52 | $40.32 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.97 / $3.74 / $9.51
| Professional | 26 | $2.97 | $3.74 | $9.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.51 / $15.78 / $30.80
| Professional | TC | $12.51 | $15.78 | $30.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.50 / $2.62 / $40.00
| Professional | 26 | $2.50 | $2.62 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $3.06 / $3.06 / $3.06
| Facility | 26 | $3.06 | $3.06 | $3.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.23 / $21.58 / $41.00
| Professional | | $15.23 | $21.58 | $41.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $2.86 / $4.22 / $9.40
| Professional | 26 | $2.86 | $4.22 | $9.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.16 / $16.92 / $31.59
| Professional | TC | $12.16 | $16.92 | $31.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.39 / $22.74 / $36.59
| Professional | | $17.39 | $22.74 | $36.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $3.75 / $4.94 / $7.90
| Professional | 26 | $3.75 | $4.94 | $7.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $13.59 / $17.57 / $27.68
| Professional | TC | $13.59 | $17.57 | $27.68 |