- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.04 / $3,908.01 / $13,841.56
| Facility | | $313.04 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $216.45 / $216.45 / $234.78
| Facility | 54 | $216.45 | $216.45 | $234.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $276.68 / $313.04 / $1,468.00
| Professional | | $276.68 | $313.04 | $1,468.00 |
- 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
- $299.57 / $501.55 / $680.86
| Professional | | $299.57 | $501.55 | $680.86 |
- 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
- $456.32 / $737.20 / $988.32
| Professional | | $456.32 | $737.20 | $988.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.60 / $516.52 / $786.85
| Facility | | $288.60 | $516.52 | $786.85 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,032.09 / $1,032.09 / $1,032.09
| Facility | 54 | $1,032.09 | $1,032.09 | $1,032.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $404.81 / $680.59 / $2,362.32
| Professional | | $404.81 | $680.59 | $2,362.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.08 / $702.11 / $988.32
| Facility | | $214.08 | $702.11 | $988.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $554.00 / $708.86 / $963.58
| Professional | | $554.00 | $708.86 | $963.58 |
- 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
- $404.81 / $607.66 / $871.89
| Professional | | $404.81 | $607.66 | $871.89 |