- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.16 / $3,908.01 / $13,841.56
| Facility | | $228.16 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $165.78 / $165.78 / $171.12
| Facility | 54 | $165.78 | $165.78 | $171.12 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $195.41 / $228.16 / $549.75
| Professional | | $195.41 | $228.16 | $549.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.20 / $226.20 / $226.20
| Professional | | $226.20 | $226.20 | $226.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $223.19 / $376.64 / $507.25
| Professional | | $223.19 | $376.64 | $507.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.40 / $193.40 / $193.40
| Facility | | $193.40 | $193.40 | $193.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $321.00 / $544.39 / $732.35
| Professional | | $321.00 | $544.39 | $732.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $221.04 / $387.87 / $561.77
| Facility | | $221.04 | $387.87 | $561.77 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $443.97 / $792.63 / $792.63
| Facility | 54 | $443.97 | $792.63 | $792.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.75 / $469.59 / $1,803.84
| Professional | | $281.75 | $469.59 | $1,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.08 / $540.74 / $719.66
| Facility | | $214.08 | $540.74 | $719.66 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $381.00 / $540.74 / $707.24
| Professional | | $381.00 | $540.74 | $707.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.75 / $469.59 / $571.73
| Professional | | $281.75 | $469.59 | $571.73 |