- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.08 / $1,497.64 / $3,554.03
| Facility | | $352.08 | $1,497.64 | $3,554.03 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $44.79 / $61.56 / $96.75
| Facility | 26 | $44.79 | $61.56 | $96.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.09 / $239.34 / $762.84
| Professional | | $160.09 | $239.34 | $762.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $54.88 / $72.66 / $254.00
| Professional | 26 | $54.88 | $72.66 | $254.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $88.53 / $147.99 / $293.94
| Professional | TC | $88.53 | $147.99 | $293.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.12 / $180.17 / $234.22
| Professional | | $126.12 | $180.17 | $234.22 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $45.03 / $65.81 / $83.63
| Professional | 26 | $45.03 | $65.81 | $83.63 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $92.67 / $162.18 / $246.20
| Professional | TC | $92.67 | $162.18 | $246.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.25 / $333.35 / $677.55
| Facility | | $119.25 | $333.35 | $677.55 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.31 / $139.00 / $266.45
| Professional | | $58.31 | $139.00 | $266.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.99 / $560.04 / $2,742.77
| Facility | | $199.99 | $560.04 | $2,742.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $187.95 / $243.23 / $333.31
| Professional | | $187.95 | $243.23 | $333.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.51 / $452.23 / $452.23
| Facility | | $179.51 | $452.23 | $452.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $63.67 / $98.93 / $98.93
| Professional | 26 | $63.67 | $98.93 | $98.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.59 / $510.25 / $1,542.00
| Facility | | $219.59 | $510.25 | $1,542.00 |
- 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
- $197.32 / $279.10 / $456.01
| Professional | | $197.32 | $279.10 | $456.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $68.89 / $93.77 / $146.15
| Professional | 26 | $68.89 | $93.77 | $146.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $135.69 / $185.54 / $313.52
| Professional | TC | $135.69 | $185.54 | $313.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.09 / $915.00 / $1,026.33
| Facility | | $397.09 | $915.00 | $1,026.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $160.72 / $305.79 / $333.40
| Facility | 26 | $160.72 | $305.79 | $333.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,949.29 / $3,949.29 / $3,949.29
| Professional | | $3,949.29 | $3,949.29 | $3,949.29 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $433.24 / $433.24 / $540.38
| Professional | 26 | $433.24 | $433.24 | $540.38 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $1,005.74 / $1,033.30 / $1,075.65
| Professional | TC | $1,005.74 | $1,033.30 | $1,075.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.90 / $270.94 / $2,378.44
| Facility | | $172.90 | $270.94 | $2,378.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $99.41 / $271.54 / $616.50
| Professional | | $99.41 | $271.54 | $616.50 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $76.64 / $104.54 / $154.57
| Professional | 26 | $76.64 | $104.54 | $154.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $143.80 / $196.14 / $296.19
| Professional | TC | $143.80 | $196.14 | $296.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $258.95 / $371.78 / $855.95
| Facility | | $258.95 | $371.78 | $855.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $74.05 / $166.53 / $339.69
| Professional | | $74.05 | $166.53 | $339.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $164.49 / $252.76 / $445.35
| Facility | | $164.49 | $252.76 | $445.35 |
- 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
- $197.32 / $281.47 / $486.78
| Professional | | $197.32 | $281.47 | $486.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $68.58 / $93.84 / $139.82
| Professional | 26 | $68.58 | $93.84 | $139.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $135.66 / $180.80 / $295.85
| Professional | TC | $135.66 | $180.80 | $295.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $170.46 / $237.44 / $414.18
| Professional | | $170.46 | $237.44 | $414.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $56.30 / $77.62 / $131.35
| Professional | 26 | $56.30 | $77.62 | $131.35 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $111.30 / $158.52 / $293.22
| Professional | TC | $111.30 | $158.52 | $293.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $160.38 / $180.17 / $255.34
| Professional | | $160.38 | $180.17 | $255.34 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $55.77 / $64.33 / $90.06
| Professional | 26 | $55.77 | $64.33 | $90.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $104.63 / $115.84 / $166.50
| Professional | TC | $104.63 | $115.84 | $166.50 |