- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $302.00 / $478.63
| Facility | | $173.78 | $302.00 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.12 / $14.45 / $17.78
| Facility | 26 | $9.12 | $14.45 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $36.31 / $245.47 / $478.63
| Facility | TC | $36.31 | $245.47 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $37.15 / $131.83
| Professional | | $9.12 | $37.15 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $16.60 / $54.95
| Professional | 26 | $7.94 | $16.60 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $30.20 / $117.49 / $165.96
| Professional | 50 | $30.20 | $117.49 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.95 / $37.15 / $83.18
| Professional | TC | $19.95 | $37.15 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $48.98 / $165.96
| Professional | | $30.20 | $48.98 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.13 / $12.59 / $43.65
| Professional | 26 | $8.13 | $12.59 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $45.71 / $72.44 / $251.19
| Professional | 50 | $45.71 | $72.44 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.38 / $36.31 / $120.23
| Professional | TC | $21.38 | $36.31 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $34.67 / $51.29
| Facility | | $11.75 | $34.67 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $28.84 / $41.69
| Professional | | $10.72 | $28.84 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $89.13 / $104.71 / $165.96
| Facility | | $89.13 | $104.71 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $21.88 / $25.12 / $40.74
| Facility | 26 | $21.88 | $25.12 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $67.61 / $79.43 / $125.89
| Facility | TC | $67.61 | $79.43 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $75.86 / $134.90
| Professional | | $33.11 | $75.86 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.91 / $17.78 / $33.88
| Professional | 26 | $8.91 | $17.78 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.99 / $57.54 / $100.00
| Professional | TC | $23.99 | $57.54 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.18 / $51.29 / $295.12
| Facility | | $28.18 | $51.29 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $223.87 / $269.15 / $354.81
| Facility | TC | $223.87 | $269.15 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.26 / $72.44 / $97.72
| Professional | | $60.26 | $72.44 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.49 / $18.62 / $25.12
| Professional | 26 | $15.49 | $18.62 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $89.13 / $107.15 / $147.91
| Professional | 50 | $89.13 | $107.15 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $44.67 / $53.70 / $67.61
| Professional | TC | $44.67 | $53.70 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28.84 / $63.10 / $346.74
| Facility | | $28.84 | $63.10 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $114.82 / $263.03 / $457.09
| Facility | TC | $114.82 | $263.03 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $69.18 / $208.93
| Professional | | $31.62 | $69.18 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.12 / $21.88 / $74.13
| Professional | 26 | $9.12 | $21.88 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $44.67 / $177.83
| Professional | TC | $22.39 | $44.67 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.65 / $85.11 / $134.90
| Professional | | $43.65 | $85.11 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $363.08 / $363.08
| Facility | | $97.72 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $100.00 / $154.88 / $154.88
| Facility | TC | $100.00 | $154.88 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.15 / $165.96 / $208.93
| Professional | | $37.15 | $165.96 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.47 / $43.65 / $74.13
| Professional | 26 | $10.47 | $43.65 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.92 / $123.03 / $177.83
| Professional | TC | $26.92 | $123.03 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.61 / $147.91 / $204.17
| Professional | | $67.61 | $147.91 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.05 / $23.44 / $39.81
| Professional | 26 | $19.05 | $23.44 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $47.86 / $52.48 / $107.15
| Professional | TC | $47.86 | $52.48 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $229.09 / $302.00
| Facility | | $229.09 | $229.09 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.62 / $45.71 / $107.15
| Professional | | $31.62 | $45.71 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.71 / $13.18 / $29.51
| Professional | 26 | $8.71 | $13.18 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.39 / $33.88 / $75.86
| Professional | TC | $22.39 | $33.88 | $75.86 |