- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.81 / $368.72 / $676.80
| Facility | | $109.81 | $368.72 | $676.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.67 / $15.65 / $18.92
| Facility | 26 | $9.67 | $15.65 | $18.92 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $54.13 / $313.52 / $451.05
| Facility | TC | $54.13 | $313.52 | $451.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.62 / $70.12 / $284.75
| Professional | | $21.62 | $70.12 | $284.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.65 / $24.47 / $99.28
| Professional | 26 | $8.65 | $24.47 | $99.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $71.70 / $312.94 / $600.00
| Professional | 50 | $71.70 | $312.94 | $600.00 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $17.60 / $21.40 / $40.85
| Professional | 52 | $17.60 | $21.40 | $40.85 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.46 / $47.07 / $206.23
| Professional | TC | $27.46 | $47.07 | $206.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.33 / $80.03 / $222.64
| Professional | | $36.33 | $80.03 | $222.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.77 / $20.28 / $56.50
| Professional | 26 | $8.77 | $20.28 | $56.50 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $55.15 / $130.60 / $369.61
| Professional | 50 | $55.15 | $130.60 | $369.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.68 / $61.14 / $173.29
| Professional | TC | $26.68 | $61.14 | $173.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.36 / $36.44 / $49.95
| Facility | | $9.36 | $36.44 | $49.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.03 / $36.56 / $54.84
| Professional | | $10.03 | $36.56 | $54.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.84 / $129.52 / $172.15
| Facility | | $110.84 | $129.52 | $172.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $23.43 / $27.38 / $36.39
| Facility | 26 | $23.43 | $27.38 | $36.39 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $87.41 / $102.14 / $135.76
| Facility | TC | $87.41 | $102.14 | $135.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.82 / $143.61 / $163.19
| Professional | | $38.82 | $143.61 | $163.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.54 / $31.83 / $36.18
| Professional | 26 | $10.54 | $31.83 | $36.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.75 / $111.77 / $127.01
| Professional | TC | $28.75 | $111.77 | $127.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.47 / $60.68 / $84.44
| Facility | | $34.47 | $60.68 | $84.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35.20 / $84.44 / $347.05
| Facility | | $35.20 | $84.44 | $347.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $66.50 / $100.00 / $162.50
| Facility | 26 | $66.50 | $100.00 | $162.50 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $143.82 / $303.39 / $517.09
| Facility | TC | $143.82 | $303.39 | $517.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $40.25 / $101.76 / $263.06
| Professional | | $40.25 | $101.76 | $263.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.02 / $30.54 / $82.72
| Professional | 26 | $11.02 | $30.54 | $82.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $29.96 / $73.31 / $205.55
| Professional | TC | $29.96 | $73.31 | $205.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.34 / $37.34 / $77.04
| Professional | | $19.34 | $37.34 | $77.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.47 / $60.68 / $84.44
| Facility | | $34.47 | $60.68 | $84.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $79.30 / $118.80 / $153.05
| Professional | | $79.30 | $118.80 | $153.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.04 / $342.77 / $342.77
| Facility | | $108.04 | $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 / $143.82 / $143.82
| Facility | TC | $100.00 | $143.82 | $143.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $62.61 / $187.75 / $263.06
| Professional | | $62.61 | $187.75 | $263.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.75 / $46.75 / $79.26
| Professional | 26 | $14.75 | $46.75 | $79.26 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $47.08 / $141.00 / $205.55
| Professional | TC | $47.08 | $141.00 | $205.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $76.86 / $229.90 / $255.92
| Professional | | $76.86 | $229.90 | $255.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.82 / $26.34 / $53.46
| Professional | 26 | $20.82 | $26.34 | $53.46 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $54.62 / $57.83 / $160.75
| Professional | TC | $54.62 | $57.83 | $160.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.70 / $82.33 / $164.56
| Professional | | $39.70 | $82.33 | $164.56 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.74 / $21.40 / $40.98
| Professional | 26 | $9.74 | $21.40 | $40.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $29.89 / $58.51 / $123.58
| Professional | TC | $29.89 | $58.51 | $123.58 |