- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.56 / $140.57 / $248.94
| Facility | | $75.56 | $140.57 | $248.94 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $40.25 / $67.94 / $86.69
| Facility | 26 | $40.25 | $67.94 | $86.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $47.58 / $84.81 / $230.90
| Professional | | $47.58 | $84.81 | $230.90 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $28.33 / $37.86 / $81.64
| Professional | 26 | $28.33 | $37.86 | $81.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $56.53 / $209.18 / $334.86
| Professional | 50 | $56.53 | $209.18 | $334.86 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $22.42 / $37.79 / $107.30
| Professional | 52 | $22.42 | $37.79 | $107.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $17.66 / $55.91 / $132.91
| Professional | TC | $17.66 | $55.91 | $132.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.00 / $284.82 / $478.25
| Facility | | $122.00 | $284.82 | $478.25 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $68.52 / $134.74 / $134.74
| Facility | 26 | $68.52 | $134.74 | $134.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.45 / $116.69 / $459.15
| Professional | | $67.45 | $116.69 | $459.15 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.65 / $72.76 / $246.68
| Professional | 26 | $40.65 | $72.76 | $246.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $47.90 / $106.10 / $165.06
| Professional | 50 | $47.90 | $106.10 | $165.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.80 / $47.02 / $313.58
| Professional | TC | $26.80 | $47.02 | $313.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.53 / $116.45 / $177.91
| Professional | | $70.53 | $116.45 | $177.91 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.22 / $54.73 / $98.41
| Professional | 26 | $32.22 | $54.73 | $98.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $27.02 / $55.55 / $97.98
| Professional | TC | $27.02 | $55.55 | $97.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.19 / $148.00 / $243.78
| Facility | | $80.19 | $148.00 | $243.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $29.45 / $61.09 / $106.70
| Facility | 26 | $29.45 | $61.09 | $106.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $77.19 / $137.29 / $198.11
| Professional | | $77.19 | $137.29 | $198.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $29.45 / $60.76 / $78.61
| Professional | 26 | $29.45 | $60.76 | $78.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $42.85 / $84.15 / $124.20
| Professional | TC | $42.85 | $84.15 | $124.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.57 / $65.14 / $147.48
| Professional | | $12.57 | $65.14 | $147.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.96 / $94.47 / $170.18
| Facility | | $58.96 | $94.47 | $170.18 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $48.94 / $59.07 / $59.63
| Facility | 26 | $48.94 | $59.07 | $59.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.84 / $32.69 / $44.22
| Professional | | $31.84 | $32.69 | $44.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.78 / $48.64 / $66.75
| Professional | 26 | $35.78 | $48.64 | $66.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.84 / $79.43 / $110.55
| Professional | TC | $23.84 | $79.43 | $110.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64.44 / $64.44 / $66.14
| Facility | | $64.44 | $64.44 | $66.14 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $39.86 / $39.86 / $40.67
| Facility | 26 | $39.86 | $39.86 | $40.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $72.17 / $109.13 / $134.22
| Professional | | $72.17 | $109.13 | $134.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $45.72 / $67.84 / $83.42
| Professional | 26 | $45.72 | $67.84 | $83.42 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.33 / $40.17 / $55.73
| Professional | TC | $26.33 | $40.17 | $55.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.74 / $361.80 / $692.47
| Facility | | $234.74 | $361.80 | $692.47 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $217.18 / $217.18 / $354.01
| Facility | 26 | $217.18 | $217.18 | $354.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.45 / $93.11 / $132.65
| Professional | | $67.45 | $93.11 | $132.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.65 / $58.51 / $78.81
| Professional | 26 | $40.65 | $58.51 | $78.81 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.80 / $34.18 / $53.38
| Professional | TC | $26.80 | $34.18 | $53.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $67.41 / $108.78 / $168.97
| Professional | | $67.41 | $108.78 | $168.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.07 / $46.41 / $86.97
| Professional | 26 | $34.07 | $46.41 | $86.97 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $33.36 / $48.44 / $83.80
| Professional | TC | $33.36 | $48.44 | $83.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $52.31 / $52.31 / $52.31
| Professional | | $52.31 | $52.31 | $52.31 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.91 / $31.91 / $31.91
| Professional | 26 | $31.91 | $31.91 | $31.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $20.39 / $20.39 / $20.39
| Professional | TC | $20.39 | $20.39 | $20.39 |