- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.68 / $467.84 / $697.20
| Facility | | $217.68 | $467.84 | $697.20 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $49.20 / $70.45 / $142.90
| Facility | 26 | $49.20 | $70.45 | $142.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $140.96 / $217.69 / $425.33
| Professional | | $140.96 | $217.69 | $425.33 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.45 / $55.46 / $104.60
| Professional | 26 | $38.45 | $55.46 | $104.60 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $100.42 / $163.53 / $250.59
| Professional | TC | $100.42 | $163.53 | $250.59 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.44 / $234.35 / $270.97
| Professional | | $124.44 | $234.35 | $270.97 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $37.86 / $64.26 / $69.47
| Professional | 26 | $37.86 | $64.26 | $69.47 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $116.07 / $116.07 / $116.07
| Professional | TC | $116.07 | $116.07 | $116.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.17 / $486.21 / $846.77
| Facility | | $306.17 | $486.21 | $846.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $54.36 / $174.10 / $174.10
| Facility | 26 | $54.36 | $174.10 | $174.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $142.80 / $255.18 / $2,210.79
| Professional | | $142.80 | $255.18 | $2,210.79 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $40.60 / $75.34 / $319.88
| Professional | 26 | $40.60 | $75.34 | $319.88 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $102.20 / $180.75 / $2,112.67
| Professional | TC | $102.20 | $180.75 | $2,112.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.00 / $240.00 / $240.00
| Facility | | $240.00 | $240.00 | $240.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $172.55 / $284.56 / $442.78
| Professional | | $172.55 | $284.56 | $442.78 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $46.96 / $79.31 / $117.86
| Professional | 26 | $46.96 | $79.31 | $117.86 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $124.81 / $203.20 / $319.67
| Professional | TC | $124.81 | $203.20 | $319.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.32 / $275.77 / $487.50
| Facility | | $158.32 | $275.77 | $487.50 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $47.60 / $81.59 / $148.52
| Facility | 26 | $47.60 | $81.59 | $148.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.36 / $248.24 / $460.72
| Professional | | $157.36 | $248.24 | $460.72 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $43.68 / $72.59 / $127.98
| Professional | 26 | $43.68 | $72.59 | $127.98 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $112.01 / $178.77 / $335.13
| Professional | TC | $112.01 | $178.77 | $335.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.87 / $139.80 / $318.93
| Professional | | $29.87 | $139.80 | $318.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.69 / $273.36 / $337.68
| Facility | | $211.69 | $273.36 | $337.68 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $63.21 / $76.08 / $98.49
| Facility | 26 | $63.21 | $76.08 | $98.49 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $57.60 / $75.86 / $99.18
| Professional | 26 | $57.60 | $75.86 | $99.18 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $149.52 / $195.64 / $265.50
| Professional | TC | $149.52 | $195.64 | $265.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.46 / $214.72 / $443.08
| Facility | | $186.46 | $214.72 | $443.08 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $53.01 / $53.01 / $54.36
| Facility | 26 | $53.01 | $53.01 | $54.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.37 / $316.52 / $405.26
| Professional | | $207.37 | $316.52 | $405.26 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $55.45 / $89.05 / $108.37
| Professional | 26 | $55.45 | $89.05 | $108.37 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $151.91 / $230.10 / $293.52
| Professional | TC | $151.91 | $230.10 | $293.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.13 / $451.10 / $846.77
| Facility | | $338.13 | $451.10 | $846.77 |
- Facility/Professional
- Facility
- Modifier
- 26
- Low / Median / High Price
- $270.73 / $270.73 / $459.43
| Facility | 26 | $270.73 | $270.73 | $459.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.66 / $165.90 / $325.74
| Professional | | $135.66 | $165.90 | $325.74 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $38.57 / $42.00 / $95.55
| Professional | 26 | $38.57 | $42.00 | $95.55 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $97.09 / $123.90 / $217.28
| Professional | TC | $97.09 | $123.90 | $217.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $186.91 / $308.55 / $456.30
| Professional | | $186.91 | $308.55 | $456.30 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $49.56 / $80.81 / $116.83
| Professional | 26 | $49.56 | $80.81 | $116.83 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $135.85 / $217.00 / $341.24
| Professional | TC | $135.85 | $217.00 | $341.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.28 / $128.22 / $146.47
| Professional | | $106.28 | $128.22 | $146.47 |
- Facility/Professional
- Professional
- Modifier
- 26
- Low / Median / High Price
- $31.75 / $37.54 / $40.15
| Professional | 26 | $31.75 | $37.54 | $40.15 |
- Facility/Professional
- Professional
- Modifier
- TC
- Low / Median / High Price
- $74.54 / $90.68 / $106.31
| Professional | TC | $74.54 | $90.68 | $106.31 |