- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.63 / $3,398.27 / $12,765.09
| Facility | | $407.63 | $3,398.27 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $305.72 / $305.72 / $343.78
| Facility | 54 | $305.72 | $305.72 | $343.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.63 / $458.37 / $2,285.96
| Professional | | $407.63 | $458.37 | $2,285.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $487.36 / $487.36 / $487.36
| Professional | | $487.36 | $487.36 | $487.36 |
- 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
- $429.99 / $722.28 / $977.25
| Professional | | $429.99 | $722.28 | $977.25 |
- 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
- $731.00 / $1,021.40 / $1,393.93
| Professional | | $731.00 | $1,021.40 | $1,393.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.53 / $756.31 / $1,992.24
| Facility | | $412.53 | $756.31 | $1,992.24 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,455.99 / $1,455.99 / $1,455.99
| Facility | 54 | $1,455.99 | $1,455.99 | $1,455.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $588.60 / $989.65 / $3,328.56
| Professional | | $588.60 | $989.65 | $3,328.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $883.00 / $1,123.72 / $1,592.75
| Facility | | $883.00 | $1,123.72 | $1,592.75 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $817.87 / $999.99 / $1,367.17
| Professional | | $817.87 | $999.99 | $1,367.17 |
- 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
- $567.54 / $989.65 / $1,267.76
| Professional | | $567.54 | $989.65 | $1,267.76 |