- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $575.44 / $1,122.02
| Facility | | $190.55 | $575.44 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $33.11 / $38.02 / $67.61
| Facility | 26 | $33.11 | $38.02 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $213.80 / $426.58
| Professional | | $162.18 | $213.80 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.88 / $44.67 / $104.71
| Professional | 26 | $33.88 | $44.67 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $128.82 / $162.18 / $288.40
| Professional | TC | $128.82 | $162.18 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.23 / $169.82 / $223.87
| Professional | | $120.23 | $169.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.90 / $37.15 / $51.29
| Professional | 26 | $30.90 | $37.15 | $51.29 |
- 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
- $177.83 / $407.38 / $741.31
| Facility | | $177.83 | $407.38 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $33.11 / $125.89 / $245.47
| Professional | | $33.11 | $125.89 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $436.52
| Facility | | $181.97 | $354.81 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.67 / $141.25 / $275.42
| Professional | | $44.67 | $141.25 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $173.78 / $173.78
| Facility | | $165.96 | $173.78 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.15 / $162.18 / $162.18
| Professional | 26 | $37.15 | $162.18 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $229.09 / $549.54 / $831.76
| Facility | | $229.09 | $549.54 | $831.76 |
- 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 / $251.19 / $426.58
| Professional | | $169.82 | $251.19 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.11 / $45.71 / $83.18
| Professional | 26 | $33.11 | $45.71 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $138.04 / $208.93 / $380.19
| Professional | TC | $138.04 | $208.93 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $234.42 / $234.42 / $234.42
| Facility | 26 | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Professional | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $363.08 / $363.08 / $363.08
| Professional | 26 | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $1,318.26
| Professional | TC | $1,202.26 | $1,202.26 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $239.88 / $436.52
| Facility | | $169.82 | $239.88 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $28.18 / $36.31 / $54.95
| Facility | 26 | $28.18 | $36.31 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.96 / $229.09 / $426.58
| Professional | | $165.96 | $229.09 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.88 / $47.86 / $91.20
| Professional | 26 | $33.88 | $47.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $128.82 / $177.83 / $323.59
| Professional | TC | $128.82 | $177.83 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $30.20 / $33.11 / $144.54
| Professional | | $30.20 | $33.11 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.42 / $489.78 / $562.34
| Professional | | $234.42 | $489.78 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $251.19 / $446.68
| Facility | | $173.78 | $251.19 | $446.68 |
- 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
- $173.78 / $251.19 / $446.68
| Professional | | $173.78 | $251.19 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $33.11 / $45.71 / $74.13
| Professional | 26 | $33.11 | $45.71 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $138.04 / $204.17 / $346.74
| Professional | TC | $138.04 | $204.17 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $380.19 / $501.19
| Facility | | $363.08 | $380.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $162.18 / $218.78 / $371.54
| Professional | | $162.18 | $218.78 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $30.20 / $40.74 / $64.57
| Professional | 26 | $30.20 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $128.82 / $181.97 / $302.00
| Professional | TC | $128.82 | $181.97 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.78 / $181.97 / $213.80
| Professional | | $173.78 | $181.97 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.31 / $38.90 / $45.71
| Professional | 26 | $36.31 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $134.90 / $141.25 / $169.82
| Professional | TC | $134.90 | $141.25 | $169.82 |