- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.38 / $288.08 / $318.97
| Facility | | $238.38 | $288.08 | $318.97 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $57.75 / $57.75 / $61.29
| Facility | TC | $57.75 | $57.75 | $61.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.32 / $63.39 / $190.00
| Professional | | $32.32 | $63.39 | $190.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $8.90 / $12.73 / $55.09
| Professional | 26 | $8.90 | $12.73 | $55.09 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.50 / $53.40 / $148.47
| Professional | TC | $25.50 | $53.40 | $148.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.93 / $40.10 / $221.00
| Professional | | $20.93 | $40.10 | $221.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.31 / $14.86 / $49.02
| Professional | 26 | $5.31 | $14.86 | $49.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.48 / $15.48 / $15.48
| Professional | TC | $15.48 | $15.48 | $15.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $36.20 / $72.86 / $140.52
| Professional | | $36.20 | $72.86 | $140.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.32 / $16.71 / $37.60
| Professional | 26 | $10.32 | $16.71 | $37.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.42 / $59.38 / $112.91
| Professional | TC | $20.42 | $59.38 | $112.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.64 / $67.14 / $163.66
| Professional | | $48.64 | $67.14 | $163.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.92 / $28.22 / $71.14
| Professional | 26 | $19.92 | $28.22 | $71.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $28.72 / $38.92 / $100.00
| Professional | TC | $28.72 | $38.92 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.06 / $73.06 / $73.06
| Facility | | $73.06 | $73.06 | $73.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.07 / $34.54 / $116.52
| Professional | | $22.07 | $34.54 | $116.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.57 / $6.96 / $28.14
| Professional | 26 | $5.57 | $6.96 | $28.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.79 / $28.30 / $90.02
| Professional | TC | $15.79 | $28.30 | $90.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.48 / $55.77 / $75.29
| Professional | | $30.48 | $55.77 | $75.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.48 / $16.85 / $24.38
| Professional | 26 | $12.48 | $16.85 | $24.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $6.10 / $43.29 / $58.44
| Professional | TC | $6.10 | $43.29 | $58.44 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $15.47 / $15.47 / $15.47
| Professional | 26 | $15.47 | $15.47 | $15.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.23 / $51.90 / $91.74
| Professional | | $43.23 | $51.90 | $91.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $9.98 / $14.98 / $18.72
| Professional | 26 | $9.98 | $14.98 | $18.72 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $31.98 / $51.79 / $64.94
| Professional | TC | $31.98 | $51.79 | $64.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.82 / $208.80 / $228.14
| Facility | | $101.82 | $208.80 | $228.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $25.85 / $100.00 / $100.00
| Facility | 26 | $25.85 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $83.75 / $164.16 / $173.52
| Facility | TC | $83.75 | $164.16 | $173.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $359.03 / $360.92 / $370.81
| Professional | | $359.03 | $360.92 | $370.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $191.54 / $191.54 / $191.54
| Professional | 26 | $191.54 | $191.54 | $191.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $268.14 / $271.66 / $275.49
| Professional | TC | $268.14 | $271.66 | $275.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.09 / $34.59 / $47.68
| Professional | | $13.09 | $34.59 | $47.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.43 / $67.50 / $98.81
| Facility | | $48.43 | $67.50 | $98.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $23.94 / $63.92 / $116.52
| Professional | | $23.94 | $63.92 | $116.52 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $5.59 / $7.17 / $32.59
| Professional | 26 | $5.59 | $7.17 | $32.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $15.79 / $30.78 / $90.02
| Professional | TC | $15.79 | $30.78 | $90.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $155.88 / $155.88 / $155.88
| Professional | | $155.88 | $155.88 | $155.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.17 / $43.17 / $43.17
| Professional | 26 | $43.17 | $43.17 | $43.17 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $112.70 / $112.70 / $112.70
| Professional | TC | $112.70 | $112.70 | $112.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $45.10 / $45.10 / $62.01
| Professional | | $45.10 | $45.10 | $62.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.00 / $105.00 / $105.00
| Facility | | $105.00 | $105.00 | $105.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $25.12 / $37.17 / $97.33
| Professional | | $25.12 | $37.17 | $97.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $6.53 / $7.32 / $25.47
| Professional | 26 | $6.53 | $7.32 | $25.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.97 / $29.95 / $79.64
| Professional | TC | $17.97 | $29.95 | $79.64 |