- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $25.32 / $33.47 / $136.66
| Facility | 26 | $25.32 | $33.47 | $136.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.14 / $63.56 / $259.64
| Professional | | $50.14 | $63.56 | $259.64 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.57 / $32.86 / $134.44
| Professional | 26 | $26.57 | $32.86 | $134.44 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $47.78 / $143.19 / $285.00
| Professional | 52 | $47.78 | $143.19 | $285.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.46 / $27.35 / $141.00
| Professional | TC | $22.46 | $27.35 | $141.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.49 / $55.33 / $139.15
| Professional | | $38.49 | $55.33 | $139.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.51 / $32.33 / $64.36
| Professional | 26 | $21.51 | $32.33 | $64.36 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $22.88 / $33.88 / $43.40
| Professional | 52 | $22.88 | $33.88 | $43.40 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $21.02 / $37.27 / $50.10
| Professional | TC | $21.02 | $37.27 | $50.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.14 / $100.64 / $176.62
| Professional | | $56.14 | $100.64 | $176.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.12 / $52.07 / $94.07
| Professional | 26 | $31.12 | $52.07 | $94.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.47 / $49.52 / $86.83
| Professional | TC | $25.47 | $49.52 | $86.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.19 / $68.50 / $155.77
| Professional | | $52.19 | $68.50 | $155.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.49 / $34.86 / $94.20
| Professional | 26 | $27.49 | $34.86 | $94.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.93 / $32.96 / $83.45
| Professional | TC | $25.93 | $32.96 | $83.45 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $32.40 / $32.40 / $32.40
| Facility | 26 | $32.40 | $32.40 | $32.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.77 / $69.79 / $152.02
| Professional | | $46.77 | $69.79 | $152.02 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.18 / $37.61 / $80.68
| Professional | 26 | $25.18 | $37.61 | $80.68 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.18 / $33.34 / $74.20
| Professional | TC | $22.18 | $33.34 | $74.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.52 / $64.69 / $87.33
| Professional | | $47.52 | $64.69 | $87.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.19 / $31.65 / $42.73
| Professional | 26 | $25.19 | $31.65 | $42.73 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.33 / $33.04 / $44.62
| Professional | TC | $22.33 | $33.04 | $44.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.75 / $236.41 / $452.20
| Professional | | $195.75 | $236.41 | $452.20 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $66.70 / $114.60 / $164.44
| Professional | 26 | $66.70 | $114.60 | $164.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $50.18 / $64.69 / $111.52
| Professional | | $50.18 | $64.69 | $111.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $28.00 / $37.97 / $59.50
| Professional | 26 | $28.00 | $37.97 | $59.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.44 / $38.19 / $61.92
| Professional | TC | $26.44 | $38.19 | $61.92 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $85.00 / $139.60 / $139.60
| Facility | 26 | $85.00 | $139.60 | $139.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.42 / $334.42 / $432.98
| Professional | | $334.42 | $334.42 | $432.98 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $182.49 / $182.49 / $229.28
| Professional | 26 | $182.49 | $182.49 | $229.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $151.88 / $151.88 / $203.70
| Professional | TC | $151.88 | $151.88 | $203.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $34.36
| Professional | | $32.34 | $32.34 | $34.36 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $32.40 / $32.40 / $32.40
| Facility | 26 | $32.40 | $32.40 | $32.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.17 / $76.84 / $148.19
| Professional | | $48.17 | $76.84 | $148.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.40 / $36.89 / $79.22
| Professional | 26 | $25.40 | $36.89 | $79.22 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $60.41 / $60.41 / $60.41
| Professional | 52 | $60.41 | $60.41 | $60.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $22.34 / $33.09 / $74.20
| Professional | TC | $22.34 | $33.09 | $74.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.65 / $181.65 / $181.65
| Professional | | $181.65 | $181.65 | $181.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $97.50 / $97.50 / $97.50
| Professional | 26 | $97.50 | $97.50 | $97.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $84.15 / $84.15 / $84.15
| Professional | TC | $84.15 | $84.15 | $84.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.31 / $66.53 / $80.79
| Professional | | $52.31 | $66.53 | $80.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.62 / $62.47 / $161.78
| Professional | | $44.62 | $62.47 | $161.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $24.15 / $33.75 / $85.36
| Professional | 26 | $24.15 | $33.75 | $85.36 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.47 / $27.96 / $71.18
| Professional | TC | $20.47 | $27.96 | $71.18 |