- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.49 / $3,908.01 / $13,841.56
| Facility | | $326.49 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $227.00 / $227.00 / $244.87
| Facility | 54 | $227.00 | $227.00 | $244.87 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $287.05 / $326.49 / $1,498.00
| Professional | | $287.05 | $326.49 | $1,498.00 |
- 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
- $312.44 / $524.07 / $710.12
| Professional | | $312.44 | $524.07 | $710.12 |
- 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
- $486.00 / $762.65 / $1,022.43
| Professional | | $486.00 | $762.65 | $1,022.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.67 / $538.71 / $825.97
| Facility | | $302.67 | $538.71 | $825.97 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,078.76 / $1,078.76 / $1,078.76
| Facility | 54 | $1,078.76 | $1,078.76 | $1,078.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $418.34 / $703.31 / $2,471.84
| Professional | | $418.34 | $703.31 | $2,471.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.08 / $721.11 / $1,022.43
| Facility | | $214.08 | $721.11 | $1,022.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $575.00 / $740.90 / $1,011.54
| Professional | | $575.00 | $740.90 | $1,011.54 |
- 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
- $418.34 / $691.87 / $901.04
| Professional | | $418.34 | $691.87 | $901.04 |