- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $46.90 / $58.79 / $336.45
| Facility | 26 | $46.90 | $58.79 | $336.45 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.86 / $247.93 / $802.00
| Professional | | $145.86 | $247.93 | $802.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $45.92 / $61.74 / $210.08
| Professional | 26 | $45.92 | $61.74 | $210.08 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $67.23 / $109.05 / $456.88
| Professional | 52 | $67.23 | $109.05 | $456.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $91.32 / $202.05 / $504.92
| Professional | TC | $91.32 | $202.05 | $504.92 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.26 / $135.12 / $296.88
| Professional | | $96.26 | $135.12 | $296.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.69 / $61.42 / $115.15
| Professional | 26 | $37.69 | $61.42 | $115.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $61.68 / $75.89 / $110.00
| Professional | TC | $61.68 | $75.89 | $110.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.69 / $322.29 / $576.55
| Professional | | $175.69 | $322.29 | $576.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $51.89 / $74.75 / $145.29
| Professional | 26 | $51.89 | $74.75 | $145.29 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $111.90 / $247.86 / $441.57
| Professional | TC | $111.90 | $247.86 | $441.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.94 / $206.80 / $512.98
| Professional | | $134.94 | $206.80 | $512.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $45.40 / $62.56 / $151.66
| Professional | 26 | $45.40 | $62.56 | $151.66 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $100.00 / $145.32 / $366.10
| Professional | TC | $100.00 | $145.32 | $366.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $58.64 / $58.64 / $58.64
| Facility | 26 | $58.64 | $58.64 | $58.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.25 / $264.92 / $499.33
| Professional | | $126.25 | $264.92 | $499.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.26 / $64.34 / $138.78
| Professional | 26 | $30.26 | $64.34 | $138.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $84.14 / $183.91 / $370.85
| Professional | TC | $84.14 | $183.91 | $370.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.32 / $172.44 / $232.79
| Professional | | $127.32 | $172.44 | $232.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.38 / $56.63 / $76.45
| Professional | 26 | $34.38 | $56.63 | $76.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $92.94 / $115.81 / $156.34
| Professional | TC | $92.94 | $115.81 | $156.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.12 / $175.97 / $292.04
| Professional | | $135.12 | $175.97 | $292.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $50.12 / $67.95 / $118.70
| Professional | 26 | $50.12 | $67.95 | $118.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $89.28 / $133.91 / $217.14
| Professional | TC | $89.28 | $133.91 | $217.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $466.96 / $466.96 / $479.84
| Facility | 26 | $466.96 | $466.96 | $479.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,609.32 / $1,657.60 / $1,657.60
| Professional | | $1,609.32 | $1,657.60 | $1,657.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $394.61 / $394.61 / $409.43
| Professional | 26 | $394.61 | $394.61 | $409.43 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $1,384.00 / $1,384.00 / $1,384.00
| Professional | TC | $1,384.00 | $1,384.00 | $1,384.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $101.49
| Professional | | $32.34 | $32.34 | $101.49 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $58.64 / $58.64 / $58.64
| Facility | 26 | $58.64 | $58.64 | $58.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.11 / $284.19 / $450.12
| Professional | | $134.11 | $284.19 | $450.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.76 / $62.71 / $136.57
| Professional | 26 | $29.76 | $62.71 | $136.57 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $157.38 / $157.38 / $159.13
| Professional | 52 | $157.38 | $157.38 | $159.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $84.14 / $186.54 / $359.30
| Professional | TC | $84.14 | $186.54 | $359.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $525.79 / $525.79 / $525.79
| Professional | | $525.79 | $525.79 | $525.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $188.55 / $188.55 / $188.55
| Professional | 26 | $188.55 | $188.55 | $188.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $337.24 / $337.24 / $337.24
| Professional | TC | $337.24 | $337.24 | $337.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.46 / $191.75 / $567.47
| Professional | | $139.46 | $191.75 | $567.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $136.51 / $205.33 / $455.23
| Professional | | $136.51 | $205.33 | $455.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $42.54 / $59.19 / $140.16
| Professional | 26 | $42.54 | $59.19 | $140.16 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $86.20 / $148.22 / $333.48
| Professional | TC | $86.20 | $148.22 | $333.48 |