- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.30 / $633.38 / $987.55
| Facility | | $105.30 | $633.38 | $987.55 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.50 / $72.92 / $298.68
| Facility | 26 | $52.50 | $72.92 | $298.68 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $110.94 / $482.60 / $865.38
| Facility | TC | $110.94 | $482.60 | $865.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $103.87 / $190.18 / $1,003.00
| Professional | | $103.87 | $190.18 | $1,003.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.54 / $77.73 / $263.89
| Professional | 26 | $32.54 | $77.73 | $263.89 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $46.75 / $62.08 / $112.28
| Professional | 52 | $46.75 | $62.08 | $112.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $64.48 / $110.94 / $448.40
| Professional | TC | $64.48 | $110.94 | $448.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $105.45 / $163.44 / $603.55
| Professional | | $105.45 | $163.44 | $603.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.86 / $55.38 / $199.68
| Professional | 26 | $33.86 | $55.38 | $199.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $71.56 / $110.94 / $403.88
| Professional | TC | $71.56 | $110.94 | $403.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36.22 / $85.92 / $136.57
| Facility | | $36.22 | $85.92 | $136.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $37.17 / $81.29 / $133.44
| Professional | | $37.17 | $81.29 | $133.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.57 / $345.39 / $529.84
| Facility | | $295.57 | $345.39 | $529.84 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $91.91 / $107.41 / $164.77
| Facility | 26 | $91.91 | $107.41 | $164.77 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $203.65 / $237.98 / $365.07
| Facility | TC | $203.65 | $237.98 | $365.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.49 / $381.08 / $433.05
| Professional | | $135.49 | $381.08 | $433.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $42.01 / $122.77 / $139.51
| Professional | 26 | $42.01 | $122.77 | $139.51 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $91.70 / $258.31 / $293.54
| Professional | TC | $91.70 | $258.31 | $293.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.44 / $163.44 / $314.42
| Facility | | $96.44 | $163.44 | $314.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.14 / $203.87 / $678.68
| Facility | | $95.14 | $203.87 | $678.68 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $157.44 / $157.44 / $531.00
| Facility | 26 | $157.44 | $157.44 | $531.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $331.53 / $583.54 / $842.53
| Facility | TC | $331.53 | $583.54 | $842.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.14 / $250.10 / $704.47
| Professional | | $122.14 | $250.10 | $704.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.60 / $87.48 / $290.60
| Professional | 26 | $39.60 | $87.48 | $290.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $83.77 / $167.37 / $483.33
| Professional | TC | $83.77 | $167.37 | $483.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $41.36 / $98.65 / $191.96
| Professional | | $41.36 | $98.65 | $191.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96.44 / $163.44 / $287.72
| Facility | | $96.44 | $163.44 | $287.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $201.58 / $307.50 / $484.50
| Professional | | $201.58 | $307.50 | $484.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.88 / $514.16 / $514.16
| Facility | | $258.88 | $514.16 | $514.16 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $157.44 / $157.44
| Facility | 26 | $100.00 | $157.44 | $157.44 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $175.48 / $331.53 / $331.53
| Facility | TC | $175.48 | $331.53 | $331.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.50 / $548.54 / $704.47
| Professional | | $160.50 | $548.54 | $704.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $51.70 / $181.50 / $290.60
| Professional | 26 | $51.70 | $181.50 | $290.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $108.80 / $367.05 / $483.33
| Professional | TC | $108.80 | $367.05 | $483.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.45 / $679.04 / $679.04
| Professional | | $303.45 | $679.04 | $679.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $106.70 / $133.52 / $199.81
| Professional | 26 | $106.70 | $133.52 | $199.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $169.93 / $217.26 / $547.75
| Professional | TC | $169.93 | $217.26 | $547.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $187.89 / $187.89 / $187.89
| Facility | | $187.89 | $187.89 | $187.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $117.97 / $213.93 / $480.80
| Professional | | $117.97 | $213.93 | $480.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.46 / $73.69 / $159.08
| Professional | 26 | $38.46 | $73.69 | $159.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $80.73 / $146.69 / $321.72
| Professional | TC | $80.73 | $146.69 | $321.72 |