- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.64 / $696.75 / $1,127.69
| Facility | | $173.64 | $696.75 | $1,127.69 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $17.12 / $34.31 / $56.74
| Facility | 26 | $17.12 | $34.31 | $56.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.59 / $129.16 / $226.23
| Professional | | $81.59 | $129.16 | $226.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.73 / $17.12 / $48.69
| Professional | 26 | $13.73 | $17.12 | $48.69 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $67.40 / $95.43 / $180.97
| Professional | TC | $67.40 | $95.43 | $180.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $190.29 / $190.29 / $190.29
| Professional | | $190.29 | $190.29 | $190.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.47 / $24.83 / $24.83
| Professional | 26 | $8.47 | $24.83 | $24.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $233.78 / $572.82 / $962.78
| Facility | | $233.78 | $572.82 | $962.78 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $131.28 / $254.31 / $902.33
| Professional | | $131.28 | $254.31 | $902.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.79 / $36.49 / $150.00
| Professional | 26 | $20.79 | $36.49 | $150.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $112.73 / $207.37 / $775.58
| Professional | TC | $112.73 | $207.37 | $775.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $475.81 / $831.68 / $1,012.37
| Facility | | $475.81 | $831.68 | $1,012.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $88.30 / $164.68 / $340.46
| Professional | | $88.30 | $164.68 | $340.46 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.55 / $28.14 / $46.81
| Professional | 26 | $16.55 | $28.14 | $46.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $71.56 / $139.09 / $291.42
| Professional | TC | $71.56 | $139.09 | $291.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.05 / $194.46 / $635.38
| Facility | | $99.05 | $194.46 | $635.38 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $15.50 / $34.86 / $635.38
| Facility | 26 | $15.50 | $34.86 | $635.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $81.97 / $178.17 / $277.91
| Professional | | $81.97 | $178.17 | $277.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.50 / $33.09 / $42.87
| Professional | 26 | $15.50 | $33.09 | $42.87 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $66.64 / $143.87 / $240.22
| Professional | TC | $66.64 | $143.87 | $240.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $27.45 / $163.00 / $277.62
| Professional | | $27.45 | $163.00 | $277.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.78 / $180.20 / $209.04
| Facility | | $125.78 | $180.20 | $209.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.91 / $30.47 / $31.49
| Facility | 26 | $24.91 | $30.47 | $31.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.48 / $25.97 / $33.14
| Professional | 26 | $18.48 | $25.97 | $33.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $77.18 / $109.44 / $152.76
| Professional | TC | $77.18 | $109.44 | $152.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.58 / $142.58 / $144.05
| Facility | | $142.58 | $142.58 | $144.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $20.39 / $20.39 / $21.02
| Facility | 26 | $20.39 | $20.39 | $21.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.94 / $241.49 / $292.44
| Professional | | $154.94 | $241.49 | $292.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.75 / $35.32 / $43.78
| Professional | 26 | $23.75 | $35.32 | $43.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $132.32 / $207.21 / $249.32
| Professional | TC | $132.32 | $207.21 | $249.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.12 / $677.62 / $1,320.55
| Facility | | $461.12 | $677.62 | $1,320.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $446.45 / $446.45 / $782.93
| Facility | 26 | $446.45 | $446.45 | $782.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $146.91 / $213.72 / $286.82
| Professional | | $146.91 | $213.72 | $286.82 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.60 / $31.51 / $43.23
| Professional | 26 | $21.60 | $31.51 | $43.23 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $126.13 / $182.21 / $249.61
| Professional | TC | $126.13 | $182.21 | $249.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10.42 / $214.48 / $220.94
| Facility | | $10.42 | $214.48 | $220.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $90.17 / $117.41 / $272.83
| Professional | | $90.17 | $117.41 | $272.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.60 / $18.37 / $43.71
| Professional | 26 | $16.60 | $18.37 | $43.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $71.20 / $96.47 / $232.99
| Professional | TC | $71.20 | $96.47 | $232.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.84 / $117.84 / $117.84
| Professional | | $117.84 | $117.84 | $117.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.14 / $16.14 / $16.14
| Professional | 26 | $16.14 | $16.14 | $16.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $101.70 / $101.70 / $101.70
| Professional | TC | $101.70 | $101.70 | $101.70 |