- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $14.65 / $15.74 / $17.77
| Facility | 26 | $14.65 | $15.74 | $17.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.11 / $45.46 / $71.50
| Professional | | $37.11 | $45.46 | $71.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.14 / $13.21 / $19.80
| Professional | 26 | $11.14 | $13.21 | $19.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.21 / $31.13 / $47.56
| Professional | TC | $25.21 | $31.13 | $47.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.58 / $49.43 / $67.86
| Professional | | $40.58 | $49.43 | $67.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.68 / $14.32 / $21.27
| Professional | 26 | $12.68 | $14.32 | $21.27 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.84 / $35.11 / $45.31
| Professional | TC | $27.84 | $35.11 | $45.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.35 / $12.20 / $40.00
| Professional | 26 | $11.35 | $12.20 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $13.91 / $13.91 / $13.91
| Facility | 26 | $13.91 | $13.91 | $13.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.42 / $50.53 / $77.01
| Professional | | $40.42 | $50.53 | $77.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.31 / $15.57 / $25.29
| Professional | 26 | $12.31 | $15.57 | $25.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.00 / $35.29 / $53.78
| Professional | TC | $28.00 | $35.29 | $53.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.20 / $41.50 / $69.44
| Professional | | $33.20 | $41.50 | $69.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.39 / $12.97 / $21.73
| Professional | 26 | $10.39 | $12.97 | $21.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $28.47 / $45.04
| Professional | TC | $22.39 | $28.47 | $45.04 |