- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $17.36 / $30.61 / $70.56
| Facility | 26 | $17.36 | $30.61 | $70.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.19 / $41.46 / $76.45
| Professional | | $36.19 | $41.46 | $76.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.99 / $12.59 / $18.51
| Professional | 26 | $10.99 | $12.59 | $18.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.95 / $29.92 / $55.94
| Professional | TC | $24.95 | $29.92 | $55.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.70 / $62.16 / $83.89
| Professional | | $37.70 | $62.16 | $83.89 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.95 / $17.72 / $23.52
| Professional | 26 | $10.95 | $17.72 | $23.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.04 / $45.39 / $60.00
| Professional | TC | $26.04 | $45.39 | $60.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.40 / $64.17 / $118.98
| Professional | | $47.40 | $64.17 | $118.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.73 / $17.66 / $34.31
| Professional | 26 | $13.73 | $17.66 | $34.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $33.34 / $46.70 / $84.81
| Professional | TC | $33.34 | $46.70 | $84.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $54.94 / $68.98 / $89.23
| Professional | | $54.94 | $68.98 | $89.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.48 / $17.70 / $24.76
| Professional | 26 | $14.48 | $17.70 | $24.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $40.11 / $50.60 / $65.53
| Professional | TC | $40.11 | $50.60 | $65.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.68 / $56.74 / $106.17
| Professional | | $39.68 | $56.74 | $106.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.14 / $16.96 / $31.31
| Professional | 26 | $12.14 | $16.96 | $31.31 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.10 / $39.03 / $76.52
| Professional | TC | $27.10 | $39.03 | $76.52 |