- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $201.39 / $648.84 / $2,258.04
| Facility | | $201.39 | $648.84 | $2,258.04 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $53.92 / $82.12 / $131.86
| Facility | 26 | $53.92 | $82.12 | $131.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $161.56 / $248.84 / $824.45
| Professional | | $161.56 | $248.84 | $824.45 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $53.92 / $77.70 / $260.00
| Professional | 26 | $53.92 | $77.70 | $260.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $137.44 / $175.12 / $368.27
| Professional | TC | $137.44 | $175.12 | $368.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.48 / $148.22 / $348.69
| Professional | | $126.48 | $148.22 | $348.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $117.95 / $121.53 / $154.47
| Professional | 26 | $117.95 | $121.53 | $154.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $188.36 / $246.23 / $632.85
| Professional | | $188.36 | $246.23 | $632.85 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $61.10 / $77.47 / $171.50
| Professional | 26 | $61.10 | $77.47 | $171.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $127.26 / $161.40 / $381.27
| Professional | TC | $127.26 | $161.40 | $381.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $99.70 / $99.70 / $187.44
| Facility | | $99.70 | $99.70 | $187.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.70 / $187.44 / $287.13
| Professional | | $99.70 | $187.44 | $287.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.59 / $496.88 / $781.42
| Facility | | $219.59 | $496.88 | $781.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $78.01 / $78.01 / $78.01
| Facility | 26 | $78.01 | $78.01 | $78.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.00 / $364.24 / $756.78
| Professional | | $170.00 | $364.24 | $756.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $66.73 / $103.02 / $222.91
| Professional | 26 | $66.73 | $103.02 | $222.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $139.16 / $259.12 / $510.75
| Professional | TC | $139.16 | $259.12 | $510.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.13 / $180.00 / $346.00
| Facility | | $107.13 | $180.00 | $346.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $213.51 / $262.69 / $604.86
| Professional | | $213.51 | $262.69 | $604.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $69.30 / $90.53 / $152.91
| Professional | 26 | $69.30 | $90.53 | $152.91 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $140.41 / $175.88 / $270.47
| Professional | TC | $140.41 | $175.88 | $270.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.57 / $208.57 / $208.57
| Facility | | $208.57 | $208.57 | $208.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $171.00 / $266.79 / $414.47
| Professional | | $171.00 | $266.79 | $414.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $56.04 / $94.92 / $145.38
| Professional | 26 | $56.04 | $94.92 | $145.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $113.70 / $176.96 / $269.08
| Professional | TC | $113.70 | $176.96 | $269.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.70 / $204.70 / $209.71
| Professional | | $204.70 | $204.70 | $209.71 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $57.64 / $72.95 / $72.95
| Professional | 26 | $57.64 | $72.95 | $72.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.25 / $822.21 / $2,198.51
| Facility | | $283.25 | $822.21 | $2,198.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $259.32 / $259.32 / $259.32
| Professional | | $259.32 | $259.32 | $259.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.59 / $555.00 / $781.42
| Facility | | $219.59 | $555.00 | $781.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $78.01 / $78.01 / $78.01
| Facility | 26 | $78.01 | $78.01 | $78.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $208.07 / $357.14 / $742.69
| Professional | | $208.07 | $357.14 | $742.69 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $66.81 / $100.93 / $213.79
| Professional | 26 | $66.81 | $100.93 | $213.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $139.40 / $226.62 / $466.00
| Professional | TC | $139.40 | $226.62 | $466.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.05 / $211.05 / $211.05
| Facility | | $211.05 | $211.05 | $211.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $193.30 / $271.16 / $573.08
| Professional | | $193.30 | $271.16 | $573.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $66.36 / $88.28 / $189.08
| Professional | 26 | $66.36 | $88.28 | $189.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $126.86 / $173.64 / $406.18
| Professional | TC | $126.86 | $173.64 | $406.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.48 / $270.48 / $823.80
| Facility | | $270.48 | $270.48 | $823.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $94.87 / $94.87 / $208.51
| Facility | 26 | $94.87 | $94.87 | $208.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.40 / $280.67 / $602.27
| Professional | | $212.40 | $280.67 | $602.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $62.98 / $99.86 / $186.96
| Professional | 26 | $62.98 | $99.86 | $186.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $137.90 / $180.82 / $346.13
| Professional | TC | $137.90 | $180.82 | $346.13 |