- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.30 / $496.12 / $971.05
| Facility | | $181.30 | $496.12 | $971.05 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $29.07 / $39.38 / $65.77
| Facility | 26 | $29.07 | $39.38 | $65.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.56 / $173.09 / $541.00
| Professional | | $120.56 | $173.09 | $541.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.44 / $29.07 / $79.00
| Professional | 26 | $18.44 | $29.07 | $79.00 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $99.50 / $141.24 / $292.77
| Professional | TC | $99.50 | $141.24 | $292.77 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.76 / $251.76 / $251.76
| Professional | | $251.76 | $251.76 | $251.76 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.69 / $35.81 / $40.15
| Professional | 26 | $12.69 | $35.81 | $40.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.18 / $323.56 / $599.46
| Facility | | $242.18 | $323.56 | $599.46 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.93 / $161.00 / $161.00
| Facility | 26 | $52.93 | $161.00 | $161.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.12 / $361.89 / $1,223.39
| Professional | | $199.12 | $361.89 | $1,223.39 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.42 / $51.58 / $237.75
| Professional | 26 | $31.42 | $51.58 | $237.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $167.71 / $299.63 / $1,114.63
| Professional | TC | $167.71 | $299.63 | $1,114.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.44 / $384.97 / $513.46
| Facility | | $234.44 | $384.97 | $513.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $179.30 / $286.44 / $473.43
| Professional | | $179.30 | $286.44 | $473.43 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $24.76 / $41.49 / $72.92
| Professional | 26 | $24.76 | $41.49 | $72.92 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $154.32 / $244.39 / $418.81
| Professional | TC | $154.32 | $244.39 | $418.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.09 / $294.07 / $483.11
| Facility | | $136.09 | $294.07 | $483.11 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $22.32 / $46.71 / $80.87
| Facility | 26 | $22.32 | $46.71 | $80.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $164.32 / $306.20 / $462.99
| Professional | | $164.32 | $306.20 | $462.99 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.01 / $44.44 / $60.75
| Professional | 26 | $22.01 | $44.44 | $60.75 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $142.74 / $258.77 / $407.81
| Professional | TC | $142.74 | $258.77 | $407.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $28.80 / $143.52 / $310.91
| Professional | | $28.80 | $143.52 | $310.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.37 / $279.62 / $298.52
| Facility | | $212.37 | $279.62 | $298.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $33.81 / $43.81 / $46.23
| Facility | 26 | $33.81 | $43.81 | $46.23 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $27.44 / $39.50 / $54.10
| Professional | 26 | $27.44 | $39.50 | $54.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $158.97 / $228.06 / $311.79
| Professional | TC | $158.97 | $228.06 | $311.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.24 / $195.24 / $197.42
| Facility | | $195.24 | $195.24 | $197.42 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $30.80 / $30.80 / $31.08
| Facility | 26 | $30.80 | $30.80 | $31.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $220.63 / $329.31 / $404.92
| Professional | | $220.63 | $329.31 | $404.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.42 / $51.84 / $63.74
| Professional | 26 | $34.42 | $51.84 | $63.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $186.10 / $277.48 / $341.18
| Professional | TC | $186.10 | $277.48 | $341.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.45 / $311.56 / $595.98
| Facility | | $229.45 | $311.56 | $595.98 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $211.40 / $211.40 / $385.75
| Facility | 26 | $211.40 | $211.40 | $385.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.12 / $283.38 / $382.54
| Professional | | $199.12 | $283.38 | $382.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.42 / $44.36 / $60.21
| Professional | 26 | $31.42 | $44.36 | $60.21 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $167.71 / $239.02 / $326.81
| Professional | TC | $167.71 | $239.02 | $326.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.49 / $273.89 / $413.24
| Professional | | $173.49 | $273.89 | $413.24 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.19 / $37.14 / $67.39
| Professional | 26 | $25.19 | $37.14 | $67.39 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $144.80 / $239.58 / $356.60
| Professional | TC | $144.80 | $239.58 | $356.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $152.58 / $152.58 / $152.58
| Professional | | $152.58 | $152.58 | $152.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.10 / $23.10 / $23.10
| Professional | 26 | $23.10 | $23.10 | $23.10 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $129.47 / $129.47 / $129.47
| Professional | TC | $129.47 | $129.47 | $129.47 |