- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.02 / $262.77 / $2,761.61
| Facility | | $97.02 | $262.77 | $2,761.61 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $51.34 / $68.01 / $107.81
| Facility | 26 | $51.34 | $68.01 | $107.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.92 / $147.01 / $267.54
| Professional | | $102.92 | $147.01 | $267.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $50.68 / $68.01 / $118.50
| Professional | 26 | $50.68 | $68.01 | $118.50 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $52.21 / $66.90 / $123.62
| Professional | 52 | $52.21 | $66.90 | $123.62 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $47.34 / $69.34 / $202.54
| Professional | TC | $47.34 | $69.34 | $202.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $97.12 / $97.12 / $114.64
| Professional | | $97.12 | $97.12 | $114.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $53.91 / $65.62 / $93.95
| Professional | 26 | $53.91 | $65.62 | $93.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,715.85 / $6,983.63 / $11,833.37
| Facility | | $2,715.85 | $6,983.63 | $11,833.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $66.73 / $122.76 / $177.46
| Professional | | $66.73 | $122.76 | $177.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $384.44 / $5,508.13 / $5,822.88
| Facility | | $384.44 | $5,508.13 | $5,822.88 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.75 / $172.61 / $258.91
| Professional | | $138.75 | $172.61 | $258.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.94 / $153.07 / $2,208.19
| Facility | | $137.94 | $153.07 | $2,208.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $76.22 / $82.03 / $83.09
| Professional | 26 | $76.22 | $82.03 | $83.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.79 / $737.83 / $9,791.54
| Facility | | $242.79 | $737.83 | $9,791.54 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $94.06 / $94.06 / $94.06
| Facility | 26 | $94.06 | $94.06 | $94.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $118.26 / $203.28 / $570.77
| Professional | | $118.26 | $203.28 | $570.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $53.02 / $77.15 / $153.06
| Professional | 26 | $53.02 | $77.15 | $153.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $55.84 / $110.25 / $419.76
| Professional | TC | $55.84 | $110.25 | $419.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.29 / $1,600.36 / $2,025.75
| Facility | | $629.29 | $1,600.36 | $2,025.75 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $188.75 / $386.03 / $386.03
| Facility | 26 | $188.75 | $386.03 | $386.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,102.49 / $3,195.57 / $3,195.57
| Professional | | $3,102.49 | $3,195.57 | $3,195.57 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $551.37 / $551.37 / $667.80
| Professional | 26 | $551.37 | $551.37 | $667.80 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $2,808.09 / $2,892.33 / $2,892.33
| Professional | TC | $2,808.09 | $2,892.33 | $2,892.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.13 / $223.11 / $703.15
| Facility | | $124.13 | $223.11 | $703.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.30 / $236.97 / $344.17
| Professional | | $164.30 | $236.97 | $344.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $101.76 / $129.16 / $313.12
| Professional | 26 | $101.76 | $129.16 | $313.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $84.94 / $107.81 / $261.36
| Professional | TC | $84.94 | $107.81 | $261.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.28 / $119.45 / $279.06
| Professional | | $51.28 | $119.45 | $279.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.49 / $256.39 / $793.00
| Facility | | $126.49 | $256.39 | $793.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $94.06 / $94.06 / $94.06
| Facility | 26 | $94.06 | $94.06 | $94.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.65 / $218.66 / $464.63
| Professional | | $125.65 | $218.66 | $464.63 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.84 / $77.15 / $146.72
| Professional | 26 | $49.84 | $77.15 | $146.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $55.93 / $108.57 / $335.40
| Professional | TC | $55.93 | $108.57 | $335.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.03 / $186.43 / $386.58
| Professional | | $142.03 | $186.43 | $386.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $52.06 / $83.79 / $132.30
| Professional | 26 | $52.06 | $83.79 | $132.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $68.90 / $102.72 / $330.49
| Professional | TC | $68.90 | $102.72 | $330.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.58 / $138.75 / $194.18
| Professional | | $122.58 | $138.75 | $194.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $66.81 / $77.01 / $105.48
| Professional | 26 | $66.81 | $77.01 | $105.48 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $55.77 / $61.74 / $88.71
| Professional | TC | $55.77 | $61.74 | $88.71 |