- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.65 / $11.93 / $23.27
| Facility | 26 | $9.65 | $11.93 | $23.27 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $51.73 / $256.83 / $571.20
| Facility | TC | $51.73 | $256.83 | $571.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.80 / $54.86 / $192.48
| Professional | | $20.80 | $54.86 | $192.48 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.71 / $18.89 / $51.00
| Professional | 26 | $9.71 | $18.89 | $51.00 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $52.74 / $155.52 / $382.50
| Professional | 50 | $52.74 | $155.52 | $382.50 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.59 / $21.18 / $26.40
| Professional | 52 | $16.59 | $21.18 | $26.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.87 / $39.71 / $107.48
| Professional | TC | $27.87 | $39.71 | $107.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.64 / $36.63 / $86.20
| Professional | | $31.64 | $36.63 | $86.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.51 / $11.40 / $19.13
| Professional | 26 | $8.51 | $11.40 | $19.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $52.55 / $52.73 / $55.83
| Professional | 50 | $52.55 | $52.73 | $55.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.71 / $53.19 / $53.90
| Professional | TC | $25.71 | $53.19 | $53.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.24 / $52.10 / $57.79
| Professional | | $48.24 | $52.10 | $57.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.80 / $16.55 / $157.08
| Professional | 26 | $12.80 | $16.55 | $157.08 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $120.46 / $160.87 / $214.44
| Facility | TC | $120.46 | $160.87 | $214.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.69 / $62.86 / $77.55
| Professional | | $45.69 | $62.86 | $77.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.03 / $17.80 / $24.81
| Professional | 26 | $11.03 | $17.80 | $24.81 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $91.37 / $125.72 / $155.13
| Professional | 50 | $91.37 | $125.72 | $155.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $34.64 / $45.07 / $55.40
| Professional | TC | $34.64 | $45.07 | $55.40 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $12.66 / $12.66 / $12.66
| Facility | 26 | $12.66 | $12.66 | $12.66 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $40.63 / $40.63 / $40.63
| Facility | TC | $40.63 | $40.63 | $40.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.03 / $51.62 / $83.29
| Professional | | $34.03 | $51.62 | $83.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.36 / $13.36 / $21.36
| Professional | 26 | $8.36 | $13.36 | $21.36 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $53.72 / $61.21 / $61.21
| Professional | 50 | $53.72 | $61.21 | $61.21 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $24.04 / $36.99 / $64.59
| Professional | TC | $24.04 | $36.99 | $64.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.41 / $61.36 / $73.95
| Professional | | $43.41 | $61.36 | $73.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.15 / $14.63 / $22.92
| Professional | 26 | $12.15 | $14.63 | $22.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $41.49 / $51.60 / $73.45
| Professional | TC | $41.49 | $51.60 | $73.45 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $181.72 / $314.33 / $470.94
| Facility | TC | $181.72 | $314.33 | $470.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.14 / $57.36 / $70.23
| Professional | | $52.14 | $57.36 | $70.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.12 / $15.34 / $24.24
| Professional | 26 | $12.12 | $15.34 | $24.24 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $25.22 / $108.44 / $130.56
| Professional | 50 | $25.22 | $108.44 | $130.56 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $40.02 / $50.67 / $62.47
| Professional | TC | $40.02 | $50.67 | $62.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $49.12 / $50.61 / $57.79
| Professional | | $49.12 | $50.61 | $57.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.40 / $14.56 / $101.99
| Professional | 26 | $12.40 | $14.56 | $101.99 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.65 / $13.02 / $29.81
| Facility | 26 | $9.65 | $13.02 | $29.81 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $41.36 / $259.70 / $704.57
| Facility | TC | $41.36 | $259.70 | $704.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.80 / $56.02 / $173.24
| Professional | | $20.80 | $56.02 | $173.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.02 / $16.48 / $47.94
| Professional | 26 | $10.02 | $16.48 | $47.94 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $52.74 / $150.57 / $382.50
| Professional | 50 | $52.74 | $150.57 | $382.50 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $19.02 / $22.61 / $42.24
| Professional | 52 | $19.02 | $22.61 | $42.24 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.92 / $44.38 / $96.86
| Professional | TC | $28.92 | $44.38 | $96.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.46 / $44.20 / $83.48
| Professional | | $12.46 | $44.20 | $83.48 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $7.17 / $12.66 / $12.66
| Facility | 26 | $7.17 | $12.66 | $12.66 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $16.73 / $40.63 / $40.63
| Facility | TC | $16.73 | $40.63 | $40.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.40 / $50.25 / $81.44
| Professional | | $34.40 | $50.25 | $81.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.64 / $13.36 / $21.78
| Professional | 26 | $8.64 | $13.36 | $21.78 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $53.72 / $61.21 / $65.11
| Professional | 50 | $53.72 | $61.21 | $65.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.55 / $36.99 / $61.55
| Professional | TC | $25.55 | $36.99 | $61.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $10.92 / $10.92 / $20.00
| Facility | 26 | $10.92 | $10.92 | $20.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $28.00 / $33.82 / $33.82
| Facility | TC | $28.00 | $33.82 | $33.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.03 / $44.74 / $48.60
| Professional | | $44.03 | $44.74 | $48.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.67 / $10.92 / $20.00
| Professional | 26 | $10.67 | $10.92 | $20.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.00 / $33.82 / $37.24
| Professional | TC | $28.00 | $33.82 | $37.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.76 / $45.37 / $78.87
| Professional | | $34.76 | $45.37 | $78.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.13 / $12.56 / $20.99
| Professional | 26 | $10.13 | $12.56 | $20.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.47 / $33.86 / $58.52
| Professional | TC | $25.47 | $33.86 | $58.52 |