- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.71 / $4,778.89 / $13,841.56
| Facility | | $438.71 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $297.94 / $297.94 / $329.03
| Facility | 54 | $297.94 | $297.94 | $329.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.25 / $438.71 / $2,244.88
| Professional | | $397.25 | $438.71 | $2,244.88 |
- 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
- $418.82 / $690.25 / $951.88
| Professional | | $418.82 | $690.25 | $951.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $681.00 / $998.03 / $1,377.53
| Professional | | $681.00 | $998.03 | $1,377.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.25 / $734.91 / $1,992.24
| Facility | | $397.25 | $734.91 | $1,992.24 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,414.67 / $1,414.67 / $1,414.67
| Facility | 54 | $1,414.67 | $1,414.67 | $1,414.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.54 / $942.30 / $3,238.64
| Professional | | $565.54 | $942.30 | $3,238.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.22 / $1,105.05 / $1,522.69
| Facility | | $889.22 | $1,105.05 | $1,522.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $779.96 / $971.62 / $1,336.91
| Professional | | $779.96 | $971.62 | $1,336.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $565.54 / $942.30 / $1,218.10
| Professional | | $565.54 | $942.30 | $1,218.10 |