- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.83 / $119.81 / $444.89
| Facility | | $113.83 | $119.81 | $444.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $11.78 / $13.05 / $13.05
| Facility | 26 | $11.78 | $13.05 | $13.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $107.01 / $135.68 / $277.36
| Professional | | $107.01 | $135.68 | $277.36 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.77 / $21.38 / $48.08
| Professional | 26 | $11.77 | $21.38 | $48.08 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $95.35 / $109.21 / $211.04
| Professional | TC | $95.35 | $109.21 | $211.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.20 / $143.93 / $258.47
| Professional | | $123.20 | $143.93 | $258.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.44 / $159.28 / $330.07
| Professional | | $120.44 | $159.28 | $330.07 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.85 / $19.64 / $38.15
| Professional | 26 | $13.85 | $19.64 | $38.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $104.46 / $140.32 / $303.54
| Professional | TC | $104.46 | $140.32 | $303.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92.60 / $222.69 / $2,144.44
| Facility | | $92.60 | $222.69 | $2,144.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.04 / $214.40 / $447.42
| Professional | | $143.04 | $214.40 | $447.42 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $11.75 / $16.79 / $40.78
| Professional | 26 | $11.75 | $16.79 | $40.78 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $131.96 / $197.94 / $407.69
| Professional | TC | $131.96 | $197.94 | $407.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.68 / $308.88 / $11,719.00
| Facility | | $147.68 | $308.88 | $11,719.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.75 / $26.75 / $26.75
| Facility | 26 | $26.75 | $26.75 | $26.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.97 / $233.45 / $446.06
| Professional | | $156.97 | $233.45 | $446.06 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.23 / $25.59 / $59.11
| Professional | 26 | $13.23 | $25.59 | $59.11 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $137.02 / $211.29 / $391.13
| Professional | TC | $137.02 | $211.29 | $391.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.75 / $109.20 / $225.84
| Professional | | $71.75 | $109.20 | $225.84 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $10.05 / $15.29 / $31.93
| Professional | 26 | $10.05 | $15.29 | $31.93 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $61.71 / $93.91 / $195.08
| Professional | TC | $61.71 | $93.91 | $195.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.27 / $186.08 / $343.26
| Professional | | $142.27 | $186.08 | $343.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $21.29 / $28.73 / $50.65
| Professional | 26 | $21.29 | $28.73 | $50.65 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $130.68 / $185.18 / $313.44
| Professional | TC | $130.68 | $185.18 | $313.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.79 / $601.01 / $708.89
| Facility | | $263.79 | $601.01 | $708.89 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $52.72 / $102.96 / $107.64
| Facility | 26 | $52.72 | $102.96 | $107.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,122.59 / $1,197.25 / $1,230.05
| Professional | | $1,122.59 | $1,197.25 | $1,230.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $198.13 / $198.13 / $198.13
| Professional | 26 | $198.13 | $198.13 | $198.13 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $934.20 / $1,126.14 / $1,157.00
| Professional | TC | $934.20 | $1,126.14 | $1,157.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $166.29
| Professional | | $32.34 | $32.34 | $166.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.72 / $176.22 / $280.93
| Facility | | $126.72 | $176.22 | $280.93 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $26.75 / $26.75 / $26.75
| Facility | 26 | $26.75 | $26.75 | $26.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.35 / $256.79 / $411.01
| Professional | | $165.35 | $256.79 | $411.01 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $13.23 / $25.33 / $55.05
| Professional | 26 | $13.23 | $25.33 | $55.05 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $137.02 / $211.35 / $369.61
| Professional | TC | $137.02 | $211.35 | $369.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $519.12 / $519.12 / $519.12
| Professional | | $519.12 | $519.12 | $519.12 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $77.84 / $77.84 / $77.84
| Professional | 26 | $77.84 | $77.84 | $77.84 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $441.28 / $441.28 / $441.28
| Professional | TC | $441.28 | $441.28 | $441.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $57.40 / $102.92 / $193.14
| Professional | | $57.40 | $102.92 | $193.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $122.92 / $175.60 / $344.66
| Professional | | $122.92 | $175.60 | $344.66 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $12.08 / $22.58 / $48.97
| Professional | 26 | $12.08 | $22.58 | $48.97 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $103.04 / $154.56 / $296.30
| Professional | TC | $103.04 | $154.56 | $296.30 |