- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $170.90 / $618.78 / $2,062.00
| Facility | | $170.90 | $618.78 | $2,062.00 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $31.39 / $40.06 / $67.80
| Facility | 26 | $31.39 | $40.06 | $67.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $131.03 / $172.55 / $272.47
| Professional | | $131.03 | $172.55 | $272.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $35.61 / $46.09 / $92.75
| Professional | 26 | $35.61 | $46.09 | $92.75 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $218.30 / $218.30 / $218.30
| Professional | 52 | $218.30 | $218.30 | $218.30 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $96.44 / $122.52 / $188.42
| Professional | TC | $96.44 | $122.52 | $188.42 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $110.40 / $119.18 / $144.75
| Professional | | $110.40 | $119.18 | $144.75 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.65 / $37.44 / $51.11
| Professional | 26 | $36.65 | $37.44 | $51.11 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $31.58 / $36.19 / $36.19
| Professional | 52 | $31.58 | $36.19 | $36.19 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $86.65 / $86.65 / $86.65
| Professional | TC | $86.65 | $86.65 | $86.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.21 / $344.15 / $647.95
| Facility | | $137.21 | $344.15 | $647.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $31.86 / $105.55 / $196.91
| Professional | | $31.86 | $105.55 | $196.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.30 / $294.77 / $533.16
| Facility | | $163.30 | $294.77 | $533.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $125.14 / $149.74 / $207.82
| Professional | | $125.14 | $149.74 | $207.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.79 / $127.33 / $136.08
| Facility | | $118.79 | $127.33 | $136.08 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $36.27 / $56.27 / $56.27
| Professional | 26 | $36.27 | $56.27 | $56.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.00 / $180.56 / $1,030.00
| Facility | | $126.00 | $180.56 | $1,030.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $138.44 / $222.46 / $354.09
| Professional | | $138.44 | $222.46 | $354.09 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $39.75 / $61.04 / $100.96
| Professional | 26 | $39.75 | $61.04 | $100.96 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $96.44 / $162.29 / $250.76
| Professional | TC | $96.44 | $162.29 | $250.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.83 / $682.58 / $2,210.79
| Facility | | $262.83 | $682.58 | $2,210.79 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $91.76 / $188.81 / $188.81
| Facility | 26 | $91.76 | $188.81 | $188.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,023.12 / $1,027.63 / $2,210.79
| Professional | | $1,023.12 | $1,027.63 | $2,210.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $261.30 / $269.14 / $308.02
| Professional | 26 | $261.30 | $269.14 | $308.02 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $767.60 / $767.60 / $2,112.67
| Professional | TC | $767.60 | $767.60 | $2,112.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.29 / $162.90 / $290.02
| Facility | | $124.29 | $162.90 | $290.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $143.21 / $217.93 / $332.94
| Professional | | $143.21 | $217.93 | $332.94 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.64 / $56.92 / $91.37
| Professional | 26 | $43.64 | $56.92 | $91.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $102.45 / $133.63 / $162.44
| Professional | TC | $102.45 | $133.63 | $162.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.19 / $66.19 / $88.40
| Facility | | $66.19 | $66.19 | $88.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $44.49 / $136.91 / $256.26
| Professional | | $44.49 | $136.91 | $256.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.29 / $163.63 / $296.33
| Facility | | $124.29 | $163.63 | $296.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $145.47 / $236.43 / $396.05
| Professional | | $145.47 | $236.43 | $396.05 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $41.17 / $59.28 / $104.64
| Professional | 26 | $41.17 | $59.28 | $104.64 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $97.19 / $162.55 / $248.74
| Professional | TC | $97.19 | $162.55 | $248.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.12 / $185.79 / $326.70
| Professional | | $135.12 | $185.79 | $326.70 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $34.07 / $50.58 / $88.27
| Professional | 26 | $34.07 | $50.58 | $88.27 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $97.03 / $138.27 / $234.36
| Professional | TC | $97.03 | $138.27 | $234.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.28 / $124.49 / $169.17
| Professional | | $106.28 | $124.49 | $169.17 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.75 / $37.39 / $50.54
| Professional | 26 | $31.75 | $37.39 | $50.54 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $74.54 / $87.10 / $118.61
| Professional | TC | $74.54 | $87.10 | $118.61 |