- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.94 / $411.96 / $1,330.10
| Facility | | $143.94 | $411.96 | $1,330.10 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $23.48 / $24.38 / $48.27
| Facility | 26 | $23.48 | $24.38 | $48.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.29 / $138.90 / $556.00
| Professional | | $38.29 | $138.90 | $556.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.72 / $25.11 / $80.47
| Professional | 26 | $18.72 | $25.11 | $80.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $95.53 / $112.49 / $192.90
| Professional | TC | $95.53 | $112.49 | $192.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $85.73 / $104.62 / $105.25
| Professional | | $85.73 | $104.62 | $105.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $16.73 / $17.62 / $35.36
| Professional | 26 | $16.73 | $17.62 | $35.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,508.00 / $6,508.00 / $6,508.00
| Facility | | $6,508.00 | $6,508.00 | $6,508.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $348.58 / $5,000.00 / $77,850.02
| Facility | | $348.58 | $5,000.00 | $77,850.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.12 / $176.59 / $285.83
| Professional | | $127.12 | $176.59 | $285.83 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.55 / $36.50 / $47.12
| Professional | 26 | $22.55 | $36.50 | $47.12 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $104.57 / $144.38 / $250.03
| Professional | TC | $104.57 | $144.38 | $250.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.59 / $251.47 / $350.45
| Facility | | $141.59 | $251.47 | $350.45 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.35 / $26.35 / $26.35
| Facility | 26 | $26.35 | $26.35 | $26.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.50 / $206.11 / $324.27
| Professional | | $133.50 | $206.11 | $324.27 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.38 / $27.07 / $45.28
| Professional | 26 | $19.38 | $27.07 | $45.28 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $114.83 / $183.55 / $278.79
| Professional | TC | $114.83 | $183.55 | $278.79 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.28 / $207.35 / $419.60
| Professional | | $164.28 | $207.35 | $419.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.03 / $33.50 / $67.79
| Professional | 26 | $27.03 | $33.50 | $67.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $136.05 / $173.84 / $351.79
| Professional | TC | $136.05 | $173.84 | $351.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.00 / $280.60 / $552.47
| Facility | | $116.00 | $280.60 | $552.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $116.40 / $162.04 / $178.25
| Professional | | $116.40 | $162.04 | $178.25 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.45 / $27.08 / $34.86
| Professional | 26 | $25.45 | $27.08 | $34.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,508.00 / $6,508.00 / $8,245.11
| Facility | | $6,508.00 | $6,508.00 | $8,245.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.97 / $354.62 / $1,206.53
| Facility | | $160.97 | $354.62 | $1,206.53 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $23.48 / $31.99 / $75.81
| Facility | 26 | $23.48 | $31.99 | $75.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.29 / $157.09 / $424.62
| Professional | | $38.29 | $157.09 | $424.62 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.48 / $31.67 / $65.06
| Professional | 26 | $20.48 | $31.67 | $65.06 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $99.13 / $128.66 / $265.39
| Professional | TC | $99.13 | $128.66 | $265.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $39.88 / $149.30 / $290.30
| Professional | | $39.88 | $149.30 | $290.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.08 / $223.50 / $342.91
| Facility | | $139.08 | $223.50 | $342.91 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.35 / $26.35 / $26.35
| Facility | 26 | $26.35 | $26.35 | $26.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.33 / $202.54 / $329.23
| Professional | | $131.33 | $202.54 | $329.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.70 / $27.07 / $46.53
| Professional | 26 | $19.70 | $27.07 | $46.53 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $114.83 / $178.59 / $278.79
| Professional | TC | $114.83 | $178.59 | $278.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $122.17 / $122.17 / $129.80
| Facility | | $122.17 | $122.17 | $129.80 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $22.28 / $22.28 / $24.59
| Facility | 26 | $22.28 | $22.28 | $24.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.16 / $123.44 / $133.01
| Professional | | $120.16 | $123.44 | $133.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.60 / $22.40 / $24.59
| Professional | 26 | $21.60 | $22.40 | $24.59 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $97.76 / $101.84 / $109.97
| Professional | TC | $97.76 | $101.84 | $109.97 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $133.57 / $173.62 / $295.11
| Professional | | $133.57 | $173.62 | $295.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.19 / $26.22 / $46.67
| Professional | 26 | $19.19 | $26.22 | $46.67 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $113.93 / $152.21 / $256.02
| Professional | TC | $113.93 | $152.21 | $256.02 |