- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.44 / $287.05 / $900.40
| Facility | | $141.44 | $287.05 | $900.40 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $29.56 / $48.01 / $67.42
| Facility | 26 | $29.56 | $48.01 | $67.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $112.95 / $149.24 / $317.67
| Professional | | $112.95 | $149.24 | $317.67 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $20.50 / $25.60 / $58.76
| Professional | 26 | $20.50 | $25.60 | $58.76 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $95.53 / $124.52 / $250.11
| Professional | TC | $95.53 | $124.52 | $250.11 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.78 / $36.78 / $39.22
| Professional | 26 | $36.78 | $36.78 | $39.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $232.86 / $343.81 / $528.33
| Facility | | $232.86 | $343.81 | $528.33 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $53.90 / $104.46 / $104.46
| Facility | 26 | $53.90 | $104.46 | $104.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.09 / $295.17 / $1,027.65
| Professional | | $163.09 | $295.17 | $1,027.65 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.88 / $53.56 / $217.94
| Professional | 26 | $31.88 | $53.56 | $217.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $133.59 / $235.17 / $889.85
| Professional | TC | $133.59 | $235.17 | $889.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.44 / $373.15 / $513.46
| Facility | | $234.44 | $373.15 | $513.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.49 / $245.19 / $386.00
| Professional | | $145.49 | $245.19 | $386.00 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $25.50 / $41.70 / $74.34
| Professional | 26 | $25.50 | $41.70 | $74.34 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $118.17 / $198.32 / $329.98
| Professional | TC | $118.17 | $198.32 | $329.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.19 / $257.52 / $406.71
| Facility | | $111.19 | $257.52 | $406.71 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $22.94 / $47.67 / $83.12
| Facility | 26 | $22.94 | $47.67 | $83.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $147.69 / $262.98 / $387.18
| Professional | | $147.69 | $262.98 | $387.18 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $22.94 / $46.70 / $62.47
| Professional | 26 | $22.94 | $46.70 | $62.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $118.18 / $212.75 / $326.82
| Professional | TC | $118.18 | $212.75 | $326.82 |
- 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
- $174.07 / $229.42 / $293.45
| Facility | | $174.07 | $229.42 | $293.45 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $37.04 / $44.90 / $46.92
| Facility | 26 | $37.04 | $44.90 | $46.92 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $28.40 / $35.50 / $51.14
| Professional | 26 | $28.40 | $35.50 | $51.14 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $113.77 / $184.92 / $249.40
| Professional | TC | $113.77 | $184.92 | $249.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.91 / $159.91 / $161.78
| Facility | | $159.91 | $159.91 | $161.78 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $31.26 / $31.26 / $31.99
| Facility | 26 | $31.26 | $31.26 | $31.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.94 / $269.85 / $331.80
| Professional | | $180.94 | $269.85 | $331.80 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.04 / $53.36 / $65.61
| Professional | 26 | $35.04 | $53.36 | $65.61 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $145.88 / $216.49 / $266.19
| Professional | TC | $145.88 | $216.49 | $266.19 |
- 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
- $163.09 / $232.72 / $313.47
| Professional | | $163.09 | $232.72 | $313.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.88 / $45.26 / $61.99
| Professional | 26 | $31.88 | $45.26 | $61.99 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $131.21 / $186.70 / $252.92
| Professional | TC | $131.21 | $186.70 | $252.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22.32 / $90.57 / $112.89
| Facility | | $22.32 | $90.57 | $112.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.63 / $228.49 / $338.88
| Professional | | $143.63 | $228.49 | $338.88 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $26.65 / $38.50 / $68.94
| Professional | 26 | $26.65 | $38.50 | $68.94 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $114.24 / $189.00 / $273.23
| Professional | TC | $114.24 | $189.00 | $273.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $134.03 / $134.03 / $134.03
| Professional | | $134.03 | $134.03 | $134.03 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $23.77 / $23.77 / $23.77
| Professional | 26 | $23.77 | $23.77 | $23.77 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $110.26 / $110.26 / $110.26
| Professional | TC | $110.26 | $110.26 | $110.26 |