- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.66 / $551.00 / $1,455.17
| Facility | | $118.66 | $551.00 | $1,455.17 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $16.18 / $19.91 / $34.95
| Facility | 26 | $16.18 | $19.91 | $34.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $100.86 / $151.71 / $302.06
| Professional | | $100.86 | $151.71 | $302.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.18 / $21.30 / $39.93
| Professional | 26 | $16.18 | $21.30 | $39.93 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $51.85 / $63.23 / $97.55
| Professional | 52 | $51.85 | $63.23 | $97.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $83.93 / $114.90 / $204.22
| Professional | TC | $83.93 | $114.90 | $204.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $83.78 / $119.68 / $146.01
| Professional | | $83.78 | $119.68 | $146.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $14.03 / $20.04 / $30.06
| Professional | 26 | $14.03 | $20.04 | $30.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $79.70 / $79.70 / $79.70
| Professional | TC | $79.70 | $79.70 | $79.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.87 / $300.83 / $574.41
| Facility | | $124.87 | $300.83 | $574.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $18.38 / $91.08 / $174.60
| Professional | | $18.38 | $91.08 | $174.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.76 / $205.67 / $432.64
| Facility | | $128.76 | $205.67 | $432.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $119.68 / $163.18 / $195.08
| Professional | | $119.68 | $163.18 | $195.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.48 / $125.19 / $128.04
| Facility | | $119.48 | $125.19 | $128.04 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.84 / $29.61 / $29.61
| Professional | 26 | $19.84 | $29.61 | $29.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.77 / $413.19 / $600.28
| Facility | | $145.77 | $413.19 | $600.28 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.72 / $24.72 / $24.72
| Facility | 26 | $24.72 | $24.72 | $24.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.59 / $177.74 / $299.00
| Professional | | $122.59 | $177.74 | $299.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.02 / $27.93 / $46.95
| Professional | 26 | $21.02 | $27.93 | $46.95 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $104.91 / $148.72 / $257.45
| Professional | TC | $104.91 | $148.72 | $257.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.45 / $696.92 / $696.92
| Facility | | $272.45 | $696.92 | $696.92 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $100.00 / $176.87 / $176.87
| Facility | 26 | $100.00 | $176.87 | $176.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,098.83 / $1,173.20 / $1,205.33
| Professional | | $1,098.83 | $1,173.20 | $1,205.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $310.41 / $310.41 / $310.41
| Professional | 26 | $310.41 | $310.41 | $310.41 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $925.73 / $1,048.79 / $1,077.52
| Professional | TC | $925.73 | $1,048.79 | $1,077.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.27 / $185.47 / $283.13
| Facility | | $120.27 | $185.47 | $283.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $92.07 / $176.16 / $284.05
| Professional | | $92.07 | $176.16 | $284.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.91 / $32.61 / $49.50
| Professional | 26 | $23.91 | $32.61 | $49.50 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $131.81 / $168.72 / $292.38
| Professional | TC | $131.81 | $168.72 | $292.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $21.45 / $119.68 / $222.50
| Professional | | $21.45 | $119.68 | $222.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.40 / $187.89 / $331.95
| Facility | | $121.40 | $187.89 | $331.95 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $24.72 / $24.72 / $24.72
| Facility | 26 | $24.72 | $24.72 | $24.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.87 / $180.01 / $327.55
| Professional | | $123.87 | $180.01 | $327.55 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.98 / $27.85 / $42.67
| Professional | 26 | $20.98 | $27.85 | $42.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $106.16 / $148.49 / $250.76
| Professional | TC | $106.16 | $148.49 | $250.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.06 / $157.93 / $269.95
| Professional | | $112.06 | $157.93 | $269.95 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.05 / $24.34 / $41.76
| Professional | 26 | $18.05 | $24.34 | $41.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $94.53 / $131.88 / $230.37
| Professional | TC | $94.53 | $131.88 | $230.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.39 / $119.68 / $170.68
| Professional | | $107.39 | $119.68 | $170.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $17.39 / $20.04 / $28.06
| Professional | 26 | $17.39 | $20.04 | $28.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $90.00 / $99.64 / $143.18
| Professional | TC | $90.00 | $99.64 | $143.18 |