- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.13 / $589.48 / $1,596.36
| Facility | | $109.13 | $589.48 | $1,596.36 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $17.48 / $21.79 / $37.76
| Facility | 26 | $17.48 | $21.79 | $37.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $95.56 / $122.77 / $209.68
| Professional | | $95.56 | $122.77 | $209.68 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $18.80 / $22.67 / $35.07
| Professional | 26 | $18.80 | $22.67 | $35.07 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $74.83 / $100.15 / $156.18
| Professional | TC | $74.83 | $100.15 | $156.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $75.28 / $91.41 / $124.75
| Professional | | $75.28 | $91.41 | $124.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.96 / $29.05 / $42.83
| Professional | 26 | $21.96 | $29.05 | $42.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $72.73 / $72.73 / $72.73
| Professional | TC | $72.73 | $72.73 | $72.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.38 / $309.33 / $583.75
| Facility | | $133.38 | $309.33 | $583.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $20.55 / $85.64 / $173.41
| Professional | | $20.55 | $85.64 | $173.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.73 / $179.73 / $254.11
| Facility | | $107.73 | $179.73 | $254.11 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.79 / $118.29 / $209.78
| Professional | | $96.79 | $118.29 | $209.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.58 / $81.58 / $112.21
| Facility | | $81.58 | $81.58 | $112.21 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.74 / $32.83 / $32.83
| Professional | 26 | $21.74 | $32.83 | $32.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.81 / $354.26 / $478.39
| Facility | | $125.81 | $354.26 | $478.39 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $27.06 / $27.06 / $27.06
| Facility | 26 | $27.06 | $27.06 | $27.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.92 / $164.22 / $285.81
| Professional | | $112.92 | $164.22 | $285.81 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.40 / $29.59 / $47.19
| Professional | 26 | $22.40 | $29.59 | $47.19 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $91.12 / $135.91 / $245.31
| Professional | TC | $91.12 | $135.91 | $245.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.18 / $623.15 / $623.15
| Facility | | $262.18 | $623.15 | $623.15 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $53.90 / $111.06 / $111.06
| Facility | 26 | $53.90 | $111.06 | $111.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $983.25 / $1,013.21 / $1,040.97
| Professional | | $983.25 | $1,013.21 | $1,040.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $217.94 / $217.94 / $217.94
| Professional | 26 | $217.94 | $217.94 | $217.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $794.40 / $889.85 / $914.23
| Professional | TC | $794.40 | $889.85 | $914.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.16 / $160.65 / $259.76
| Facility | | $109.16 | $160.65 | $259.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.54 / $169.34 / $268.77
| Professional | | $107.54 | $169.34 | $268.77 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.18 / $35.71 / $52.54
| Professional | 26 | $26.18 | $35.71 | $52.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $106.24 / $144.91 / $216.24
| Professional | TC | $106.24 | $144.91 | $216.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $22.48 / $98.83 / $322.39
| Professional | | $22.48 | $98.83 | $322.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.55 / $164.99 / $295.67
| Facility | | $109.55 | $164.99 | $295.67 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $27.06 / $27.06 / $27.06
| Facility | 26 | $27.06 | $27.06 | $27.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $113.46 / $171.50 / $306.60
| Professional | | $113.46 | $171.50 | $306.60 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.40 / $29.11 / $44.01
| Professional | 26 | $22.40 | $29.11 | $44.01 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $91.20 / $135.91 / $244.03
| Professional | TC | $91.20 | $135.91 | $244.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.74 / $180.78 / $191.41
| Facility | | $110.74 | $180.78 | $191.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.63 / $144.66 / $245.72
| Professional | | $101.63 | $144.66 | $245.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.07 / $25.65 / $42.94
| Professional | 26 | $19.07 | $25.65 | $42.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $78.53 / $118.38 / $196.34
| Professional | TC | $78.53 | $118.38 | $196.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $96.35 / $107.54 / $153.16
| Professional | | $96.35 | $107.54 | $153.16 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $19.05 / $21.96 / $30.74
| Professional | 26 | $19.05 | $21.96 | $30.74 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $77.30 / $85.58 / $123.01
| Professional | TC | $77.30 | $85.58 | $123.01 |