- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $707.95 / $1,513.56
| Facility | | $245.47 | $707.95 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $39.81 / $64.57 / $138.04
| Facility | 26 | $39.81 | $64.57 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $239.88 / $512.86
| Professional | | $165.96 | $239.88 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.67 / $48.98 / $114.82
| Professional | 26 | $34.67 | $48.98 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $128.82 / $169.82 / $316.23
| Professional | TC | $128.82 | $169.82 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $141.25 / $323.59
| Professional | | $120.23 | $141.25 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.90 / $53.70 / $58.88
| Professional | 26 | $30.90 | $53.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $109.65 / $109.65 / $109.65
| Professional | TC | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $5,011.87 / $77,624.71
| Facility | | $245.47 | $5,011.87 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $177.83 / $338.84
| Professional | | $173.78 | $177.83 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.02 / $39.81 / $74.13
| Professional | 26 | $38.02 | $39.81 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $134.90 / $141.25 / $269.15
| Professional | TC | $134.90 | $141.25 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $389.05 / $616.60
| Facility | | $165.96 | $389.05 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $9.33 / $43.65 / $63.10
| Facility | 26 | $9.33 | $43.65 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $245.47 / $389.05
| Professional | | $169.82 | $245.47 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $32.36 / $42.66 / $74.13
| Professional | 26 | $32.36 | $42.66 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $134.90 / $204.17 / $331.13
| Professional | TC | $134.90 | $204.17 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $251.19 / $323.59
| Professional | | $218.78 | $251.19 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.65 / $52.48 / $66.07
| Professional | 26 | $43.65 | $52.48 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $173.78 / $194.98 / $257.04
| Professional | TC | $173.78 | $194.98 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.89 / $218.78 / $354.81
| Professional | | $125.89 | $218.78 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.62 / $45.71 / $69.18
| Professional | 26 | $31.62 | $45.71 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $93.33 / $177.83 / $275.42
| Professional | TC | $93.33 | $177.83 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $691.83 / $1,023.29
| Facility | | $467.74 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $56.23 / $56.23 / $56.23
| Facility | 26 | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Professional | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.81 / $43.65 / $50.12
| Professional | 26 | $39.81 | $43.65 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $676.08 / $1,445.44
| Facility | | $245.47 | $676.08 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $38.90 / $56.23 / $125.89
| Facility | 26 | $38.90 | $56.23 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $169.82 / $251.19 / $501.19
| Professional | | $169.82 | $251.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.67 / $52.48 / $104.71
| Professional | 26 | $34.67 | $52.48 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $134.90 / $194.98 / $389.05
| Professional | TC | $134.90 | $194.98 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $389.05
| Facility | | $371.54 | $371.54 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $346.74 / $489.78
| Professional | | $234.42 | $346.74 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $162.18 / $199.53
| Facility | | $81.28 | $162.18 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $37.15 / $38.90 / $38.90
| Facility | 26 | $37.15 | $38.90 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $48.98 / $93.33 / $199.53
| Professional | | $48.98 | $93.33 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.15 / $37.15 / $38.90
| Professional | 26 | $37.15 | $37.15 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $131.83 / $134.90 / $162.18
| Professional | TC | $131.83 | $134.90 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $660.69 / $851.14
| Facility | | $363.08 | $660.69 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.88 / $204.17 / $363.08
| Professional | | $154.88 | $204.17 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.62 / $40.74 / $70.79
| Professional | 26 | $31.62 | $40.74 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $128.82 / $169.82 / $295.12
| Professional | TC | $128.82 | $169.82 | $295.12 |