- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.44 / $2,491.87 / $3,843.10
| Facility | | $532.44 | $2,491.87 | $3,843.10 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $24.87 / $24.87 / $106.49
| Facility | 53 | $24.87 | $24.87 | $106.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $124.35 / $448.50 / $1,199.07
| Professional | | $124.35 | $448.50 | $1,199.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $376.05 / $1,689.00 / $4,689.00
| Facility | | $376.05 | $1,689.00 | $4,689.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $156.37 / $156.37 / $156.37
| Facility | 53 | $156.37 | $156.37 | $156.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.41 / $869.70 / $2,210.60
| Professional | | $177.41 | $869.70 | $2,210.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.06 / $237.98 / $466.80
| Facility | | $183.06 | $237.98 | $466.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $256.64 / $596.71 / $1,191.03
| Professional | | $256.64 | $596.71 | $1,191.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.92 / $824.18 / $1,823.87
| Professional | | $284.92 | $824.18 | $1,823.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.07 / $333.80 / $6,679.00
| Facility | | $161.07 | $333.80 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $564.78 / $713.66 / $1,275.98
| Professional | | $564.78 | $713.66 | $1,275.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $202.37 / $596.38 / $1,324.02
| Professional | | $202.37 | $596.38 | $1,324.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,160.72 / $2,729.08 / $4,633.56
| Facility | | $1,160.72 | $2,729.08 | $4,633.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $322.27 / $458.97 / $1,234.63
| Professional | | $322.27 | $458.97 | $1,234.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,376.00 / $8,498.00
| Facility | | $55.00 | $2,376.00 | $8,498.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $156.37 / $156.37 / $156.37
| Facility | 53 | $156.37 | $156.37 | $156.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $748.45 / $1,337.12 / $3,502.96
| Professional | | $748.45 | $1,337.12 | $3,502.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,372.00 / $8,425.00
| Facility | | $1,640.00 | $3,372.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.75 / $1,040.27 / $1,797.74
| Professional | | $724.75 | $1,040.27 | $1,797.74 |