- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.54 / $283.70 / $742.56
| Facility | | $67.54 | $283.70 | $742.56 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $5.61 / $7.29 / $19.71
| Facility | 26 | $5.61 | $7.29 | $19.71 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $14.31 / $221.96 / $406.58
| Facility | TC | $14.31 | $221.96 | $406.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.73 / $21.61 / $60.15
| Professional | | $16.73 | $21.61 | $60.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.12 / $9.05 / $32.13
| Professional | 26 | $6.12 | $9.05 | $32.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $10.64 / $13.89 / $26.22
| Professional | TC | $10.64 | $13.89 | $26.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.32 / $21.79 / $39.86
| Professional | | $19.32 | $21.79 | $39.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.61 / $11.65 / $16.12
| Professional | 26 | $6.61 | $11.65 | $16.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $12.71 / $13.51 / $20.66
| Professional | TC | $12.71 | $13.51 | $20.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.64 / $191.54 / $336.80
| Facility | | $77.64 | $191.54 | $336.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $7.14 / $18.64 / $27.96
| Professional | | $7.14 | $18.64 | $27.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.16 / $145.28 / $261.22
| Facility | | $24.16 | $145.28 | $261.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $24.08 / $33.00 / $45.63
| Professional | | $24.08 | $33.00 | $45.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24.07 / $25.02 / $84.13
| Facility | | $24.07 | $25.02 | $84.13 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $15.63 / $15.89 / $17.00
| Facility | TC | $15.63 | $15.89 | $17.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.18 / $8.26 / $8.63
| Professional | 26 | $8.18 | $8.26 | $8.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.64 / $115.19 / $304.81
| Facility | | $53.64 | $115.19 | $304.81 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.67 / $9.67 / $9.67
| Facility | 26 | $9.67 | $9.67 | $9.67 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $19.39 / $19.39 / $19.39
| Facility | TC | $19.39 | $19.39 | $19.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.20 / $24.00 / $45.92
| Professional | | $17.20 | $24.00 | $45.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.96 / $9.96 / $17.78
| Professional | 26 | $6.96 | $9.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $9.58 / $14.95 / $29.46
| Professional | TC | $9.58 | $14.95 | $29.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52.92 / $359.91 / $359.91
| Facility | | $52.92 | $359.91 | $359.91 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $20.47 / $70.00 / $70.00
| Facility | 26 | $20.47 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $36.54 / $94.62 / $94.62
| Facility | TC | $36.54 | $94.62 | $94.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.42 / $165.42 / $218.63
| Professional | | $165.42 | $165.42 | $218.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $55.28 / $55.28 / $70.34
| Professional | 26 | $55.28 | $55.28 | $70.34 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $110.07 / $110.07 / $148.28
| Professional | TC | $110.07 | $110.07 | $148.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.87 / $28.99 / $478.70
| Facility | | $19.87 | $28.99 | $478.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.30 / $29.70 / $70.20
| Professional | | $13.30 | $29.70 | $70.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.93 / $15.01 / $33.64
| Professional | 26 | $10.93 | $15.01 | $33.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.87 / $32.79 / $44.15
| Professional | TC | $21.87 | $32.79 | $44.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.27 / $1,448.83 / $2,838.00
| Facility | | $964.27 | $1,448.83 | $2,838.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.49 / $21.30 / $44.13
| Professional | | $9.49 | $21.30 | $44.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.52 / $26.49 / $73.93
| Facility | | $19.52 | $26.49 | $73.93 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.67 / $9.67 / $9.67
| Facility | 26 | $9.67 | $9.67 | $9.67 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $19.39 / $19.39 / $19.39
| Facility | TC | $19.39 | $19.39 | $19.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $17.73 / $27.82 / $62.09
| Professional | | $17.73 | $27.82 | $62.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.11 / $9.68 / $17.53
| Professional | 26 | $7.11 | $9.68 | $17.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $9.21 / $14.95 / $27.56
| Professional | TC | $9.21 | $14.95 | $27.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.64 / $153.71 / $185.87
| Facility | | $77.64 | $153.71 | $185.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.11 / $24.68 / $43.70
| Professional | | $18.11 | $24.68 | $43.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.50 / $9.36 / $15.33
| Professional | 26 | $7.50 | $9.36 | $15.33 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $9.69 / $15.07 / $23.82
| Professional | TC | $9.69 | $15.07 | $23.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.53 / $24.16 / $34.22
| Professional | | $21.53 | $24.16 | $34.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.18 / $8.26 / $11.41
| Professional | 26 | $7.18 | $8.26 | $11.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.36 / $15.89 / $22.82
| Professional | TC | $14.36 | $15.89 | $22.82 |