- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.72 / $5,463.36 / $13,841.56
| Facility | | $474.72 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $356.04 / $356.04 / $377.39
| Facility | 54 | $356.04 | $356.04 | $377.39 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.72 / $567.14 / $2,488.21
| Professional | | $474.72 | $567.14 | $2,488.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $432.09 / $551.13 / $551.13
| Professional | | $432.09 | $551.13 | $551.13 |
- 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
- $481.55 / $817.38 / $1,094.44
| Professional | | $481.55 | $817.38 | $1,094.44 |
- 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
- $832.00 / $1,188.13 / $1,599.71
| Professional | | $832.00 | $1,188.13 | $1,599.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.72 / $855.42 / $2,369.15
| Facility | | $474.72 | $855.42 | $2,369.15 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,688.06 / $1,688.06 / $1,688.06
| Facility | 54 | $1,688.06 | $1,688.06 | $1,688.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $654.36 / $1,113.08 / $3,865.12
| Professional | | $654.36 | $1,113.08 | $3,865.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,019.37 / $1,257.44 / $1,602.01
| Facility | | $1,019.37 | $1,257.44 | $1,602.01 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $946.00 / $1,160.30 / $1,599.71
| Professional | | $946.00 | $1,160.30 | $1,599.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,775.00 / $3,227.00 / $6,169.00
| Facility | | $1,775.00 | $3,227.00 | $6,169.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $654.36 / $1,113.08 / $1,409.38
| Professional | | $654.36 | $1,113.08 | $1,409.38 |