- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.81 / $358.00 / $590.72
| Facility | | $173.81 | $358.00 | $590.72 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.93 / $14.47 / $17.48
| Facility | 26 | $8.93 | $14.47 | $17.48 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $48.96 / $313.12 / $791.44
| Facility | TC | $48.96 | $313.12 | $791.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.68 / $64.16 / $276.70
| Professional | | $21.68 | $64.16 | $276.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.00 / $21.68 / $101.33
| Professional | 26 | $8.00 | $21.68 | $101.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $134.40 / $620.00 / $690.00
| Professional | 50 | $134.40 | $620.00 | $690.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.52 / $42.58 / $184.96
| Professional | TC | $24.52 | $42.58 | $184.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.53 / $72.76 / $202.57
| Professional | | $32.53 | $72.76 | $202.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.11 / $18.76 / $52.25
| Professional | 26 | $8.11 | $18.76 | $52.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $49.32 / $117.22 / $328.98
| Professional | 50 | $49.32 | $117.22 | $328.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.58 / $54.03 / $156.93
| Professional | TC | $23.58 | $54.03 | $156.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8.69 / $33.38 / $45.91
| Facility | | $8.69 | $33.38 | $45.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.28 / $33.54 / $50.33
| Professional | | $9.28 | $33.54 | $50.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.93 / $117.94 / $156.75
| Facility | | $100.93 | $117.94 | $156.75 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $21.63 / $25.27 / $33.59
| Facility | 26 | $21.63 | $25.27 | $33.59 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $79.30 / $92.67 / $123.16
| Facility | TC | $79.30 | $92.67 | $123.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.31 / $130.68 / $148.50
| Professional | | $34.31 | $130.68 | $148.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.52 / $29.44 / $33.45
| Professional | 26 | $9.52 | $29.44 | $33.45 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.63 / $101.24 / $115.05
| Professional | TC | $25.63 | $101.24 | $115.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.80 / $45.53 / $75.44
| Facility | | $30.80 | $45.53 | $75.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.02 / $107.84 / $303.94
| Facility | | $32.02 | $107.84 | $303.94 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $61.75 / $100.00 / $164.00
| Facility | 26 | $61.75 | $100.00 | $164.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $120.41 / $248.23 / $462.22
| Facility | TC | $120.41 | $248.23 | $462.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.53 / $88.28 / $234.86
| Professional | | $35.53 | $88.28 | $234.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.86 / $25.71 / $68.64
| Professional | 26 | $9.86 | $25.71 | $68.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.35 / $62.22 / $181.68
| Professional | TC | $26.35 | $62.22 | $181.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.34 / $33.89 / $74.33
| Professional | | $19.34 | $33.89 | $74.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.80 / $47.25 / $75.44
| Facility | | $30.80 | $47.25 | $75.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.80 / $109.07 / $137.12
| Professional | | $72.80 | $109.07 | $137.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.44 / $342.77 / $342.77
| Facility | | $95.44 | $342.77 | $342.77 |
- 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 / $131.69 / $131.69
| Facility | TC | $100.00 | $131.69 | $131.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $55.83 / $167.10 / $234.86
| Professional | | $55.83 | $167.10 | $234.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.64 / $43.25 / $67.70
| Professional | 26 | $13.64 | $43.25 | $67.70 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $42.64 / $123.90 / $181.68
| Professional | TC | $42.64 | $123.90 | $181.68 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.15 / $206.32 / $232.86
| Professional | | $66.15 | $206.32 | $232.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.26 / $24.37 / $47.48
| Professional | 26 | $19.26 | $24.37 | $47.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $46.89 / $57.67 / $138.21
| Professional | TC | $46.89 | $57.67 | $138.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.04 / $104.04 / $104.04
| Facility | | $104.04 | $104.04 | $104.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.53 / $63.50 / $140.44
| Professional | | $35.53 | $63.50 | $140.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.44 / $20.30 / $37.90
| Professional | 26 | $9.44 | $20.30 | $37.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.35 / $53.25 / $108.55
| Professional | TC | $26.35 | $53.25 | $108.55 |