- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.76 / $253.92 / $747.25
| Facility | | $50.76 | $253.92 | $747.25 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $8.03 / $8.03 / $8.19
| Facility | 26 | $8.03 | $8.03 | $8.19 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $82.61 / $245.74 / $448.94
| Facility | TC | $82.61 | $245.74 | $448.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.03 / $28.96 / $43.79
| Professional | | $15.03 | $28.96 | $43.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $7.11 / $8.64 / $45.60
| Professional | 26 | $7.11 | $8.64 | $45.60 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $16.52 / $16.52 / $16.52
| Professional | 50 | $16.52 | $16.52 | $16.52 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.72 / $22.91 / $55.23
| Professional | TC | $20.72 | $22.91 | $55.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $94.00 / $156.00 / $156.00
| Professional | | $94.00 | $156.00 | $156.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.00 / $35.00 / $35.00
| Professional | 26 | $21.00 | $35.00 | $35.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $73.00 / $121.00 / $121.00
| Professional | TC | $73.00 | $121.00 | $121.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.95 / $45.07 / $85.53
| Professional | | $30.95 | $45.07 | $85.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.22 / $13.18 / $23.13
| Professional | 26 | $9.22 | $13.18 | $23.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.64 / $31.02 / $61.73
| Professional | TC | $21.64 | $31.02 | $61.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.28 / $62.12 / $104.51
| Professional | | $32.28 | $62.12 | $104.51 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.50 / $15.84 / $27.06
| Professional | 26 | $8.50 | $15.84 | $27.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.78 / $45.26 / $76.68
| Professional | TC | $23.78 | $45.26 | $76.68 |