- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.54 / $137.13 / $162.13
| Facility | | $34.54 | $137.13 | $162.13 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $19.60 / $22.53 / $77.15
| Facility | 26 | $19.60 | $22.53 | $77.15 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $14.94 / $294.72 / $445.55
| Facility | TC | $14.94 | $294.72 | $445.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $34.20 / $76.00 / $200.54
| Professional | | $34.20 | $76.00 | $200.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.47 / $28.18 / $104.96
| Professional | 26 | $19.47 | $28.18 | $104.96 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $234.74 / $234.74 / $281.35
| Professional | 50 | $234.74 | $234.74 | $281.35 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.25 / $20.68 / $68.56
| Professional | 52 | $16.25 | $20.68 | $68.56 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $14.49 / $24.06 / $97.50
| Professional | TC | $14.49 | $24.06 | $97.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $43.79 / $71.95 / $150.83
| Professional | | $43.79 | $71.95 | $150.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.42 / $35.22 / $65.04
| Professional | 26 | $20.42 | $35.22 | $65.04 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $65.68 / $107.94 / $226.24
| Professional | 50 | $65.68 | $107.94 | $226.24 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $19.29 / $32.52 / $92.55
| Professional | TC | $19.29 | $32.52 | $92.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.93 / $24.92 / $45.95
| Facility | | $15.93 | $24.92 | $45.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $16.64 / $23.83 / $45.41
| Professional | | $16.64 | $23.83 | $45.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.02 / $116.89 / $155.35
| Facility | | $100.02 | $116.89 | $155.35 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $54.97 / $64.23 / $85.37
| Facility | 26 | $54.97 | $64.23 | $85.37 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $45.06 / $52.65 / $69.98
| Facility | TC | $45.06 | $52.65 | $69.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $56.36 / $77.81 / $127.06
| Professional | | $56.36 | $77.81 | $127.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.33 / $41.55 / $50.84
| Professional | 26 | $25.33 | $41.55 | $50.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $26.17 / $37.47 / $58.55
| Professional | TC | $26.17 | $37.47 | $58.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.49 / $52.70 / $117.15
| Facility | | $32.49 | $52.70 | $117.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.20 / $59.40 / $232.02
| Facility | | $34.20 | $59.40 | $232.02 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $70.31 / $141.03 / $243.10
| Facility | TC | $70.31 | $141.03 | $243.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $51.08 / $108.23 / $402.37
| Professional | | $51.08 | $108.23 | $402.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $24.08 / $42.45 / $130.60
| Professional | 26 | $24.08 | $42.45 | $130.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $25.71 / $63.05 / $284.52
| Professional | TC | $25.71 | $63.05 | $284.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $19.71 / $48.79 / $73.66
| Professional | | $19.71 | $48.79 | $73.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.49 / $52.70 / $132.29
| Facility | | $32.49 | $52.70 | $132.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $68.65 / $86.77 / $124.92
| Professional | | $68.65 | $86.77 | $124.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $88.80 / $232.02 / $232.02
| Facility | | $88.80 | $232.02 | $232.02 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | 26 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- TC
- Low / Median / High Price
- $100.00 / $141.03 / $141.03
| Facility | TC | $100.00 | $141.03 | $141.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.58 / $263.29 / $402.37
| Professional | | $74.58 | $263.29 | $402.37 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.11 / $117.91 / $130.60
| Professional | 26 | $39.11 | $117.91 | $130.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $33.01 / $173.20 / $284.52
| Professional | TC | $33.01 | $173.20 | $284.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.66 / $130.82 / $138.43
| Professional | | $75.66 | $130.82 | $138.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.01 / $41.26 / $109.06
| Professional | 26 | $30.01 | $41.26 | $109.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.35 / $39.29 / $125.90
| Professional | TC | $23.35 | $39.29 | $125.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $46.19 / $86.25 / $153.22
| Professional | | $46.19 | $86.25 | $153.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.58 / $40.95 / $74.90
| Professional | 26 | $23.58 | $40.95 | $74.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $23.82 / $49.74 / $84.74
| Professional | TC | $23.82 | $49.74 | $84.74 |