- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $363.08 / $630.96
| Facility | | $134.90 | $363.08 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.55 / $14.45 / $21.38
| Facility | 26 | $9.55 | $14.45 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $56.23 / $302.00 / $602.56
| Facility | TC | $56.23 | $302.00 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.12 / $43.65 / $162.18
| Professional | | $9.12 | $43.65 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.94 / $17.78 / $64.57
| Professional | 26 | $7.94 | $17.78 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $18.20 / $95.50 / $234.42
| Professional | 50 | $18.20 | $95.50 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.92 / $50.12 / $134.90
| Professional | TC | $26.92 | $50.12 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $61.66 / $194.98
| Professional | | $36.31 | $61.66 | $194.98 |
- 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
- $53.70 / $91.20 / $288.40
| Professional | 50 | $53.70 | $91.20 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.92 / $48.98 / $151.36
| Professional | TC | $26.92 | $48.98 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11.75 / $46.77 / $64.57
| Facility | | $11.75 | $46.77 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.72 / $39.81 / $52.48
| Professional | | $10.72 | $39.81 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $131.83 / $208.93
| Facility | | $112.20 | $131.83 | $208.93 |
- 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
- $89.13 / $104.71 / $169.82
| Facility | TC | $89.13 | $104.71 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.31 / $93.33 / $165.96
| Professional | | $36.31 | $93.33 | $165.96 |
- 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
- $27.54 / $70.79 / $134.90
| Professional | TC | $27.54 | $70.79 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $61.66 / $295.12
| Facility | | $33.88 | $61.66 | $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
- $75.86 / $91.20 / $123.03
| Professional | | $75.86 | $91.20 | $123.03 |
- 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
- $114.82 / $134.90 / $186.21
| Professional | 50 | $114.82 | $134.90 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $60.26 / $72.44 / $97.72
| Professional | TC | $60.26 | $72.44 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38.02 / $173.78 / $346.74
| Facility | | $38.02 | $173.78 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $61.66 / $100.00 / $186.21
| Facility | 26 | $61.66 | $100.00 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $151.36 / $302.00 / $467.74
| Facility | TC | $151.36 | $302.00 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.02 / $89.13 / $263.03
| Professional | | $38.02 | $89.13 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.33 / $23.44 / $75.86
| Professional | 26 | $9.33 | $23.44 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.18 / $54.95 / $208.93
| Professional | TC | $28.18 | $54.95 | $208.93 |
- 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
- $56.23 / $109.65 / $151.36
| Professional | | $56.23 | $109.65 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.82 / $363.08 / $363.08
| Facility | | $114.82 | $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 / $208.93 / $208.93
| Facility | TC | $100.00 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.69 / $234.42 / $263.03
| Professional | | $41.69 | $234.42 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.47 / $43.65 / $67.61
| Professional | 26 | $10.47 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $31.62 / $144.54 / $208.93
| Professional | TC | $31.62 | $144.54 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.86 / $181.97 / $257.04
| Professional | | $75.86 | $181.97 | $257.04 |
- 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
- $48.98 / $56.23 / $144.54
| Professional | TC | $48.98 | $56.23 | $144.54 |
- 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
- $36.31 / $52.48 / $128.82
| Professional | | $36.31 | $52.48 | $128.82 |
- 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
- $28.18 / $40.74 / $97.72
| Professional | TC | $28.18 | $40.74 | $97.72 |