- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37.53 / $278.39 / $871.62
| Facility | | $37.53 | $278.39 | $871.62 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.68 / $8.68 / $8.86
| Facility | 26 | $8.68 | $8.68 | $8.86 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $245.74 / $298.30 / $667.42
| Facility | TC | $245.74 | $298.30 | $667.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.90 / $27.71 / $46.04
| Professional | | $8.90 | $27.71 | $46.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.59 / $9.14 / $21.86
| Professional | 26 | $7.59 | $9.14 | $21.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $17.86 / $17.86 / $33.27
| Professional | 50 | $17.86 | $17.86 | $33.27 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $18.73 / $21.69 / $130.15
| Professional | TC | $18.73 | $21.69 | $130.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.00 / $146.00 / $146.00
| Professional | | $89.00 | $146.00 | $146.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.00 / $38.00 / $38.00
| Professional | 26 | $23.00 | $38.00 | $38.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $66.00 / $108.00 / $108.00
| Professional | TC | $66.00 | $108.00 | $108.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.59 / $43.13 / $81.75
| Professional | | $29.59 | $43.13 | $81.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.94 / $14.24 / $27.22
| Professional | 26 | $9.94 | $14.24 | $27.22 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.12 / $27.39 / $54.61
| Professional | TC | $19.12 | $27.39 | $54.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.26 / $58.94 / $100.68
| Professional | | $31.26 | $58.94 | $100.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.19 / $17.11 / $29.71
| Professional | 26 | $10.19 | $17.11 | $29.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.07 / $40.92 / $68.20
| Professional | TC | $21.07 | $40.92 | $68.20 |