- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,320.00 / $4,241.22 / $13,841.56
| Facility | | $1,320.00 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $60.13 / $114.89 / $982.56
| Facility | 52 | $60.13 | $114.89 | $982.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $120.25 / $229.77 / $707.19
| Professional | | $120.25 | $229.77 | $707.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $284.39 / $284.39 / $284.39
| Professional | | $284.39 | $284.39 | $284.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,616.14 / $6,256.05 / $11,744.20
| Facility | | $4,616.14 | $6,256.05 | $11,744.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.47 / $246.24 / $471.02
| Professional | | $127.47 | $246.24 | $471.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $290.60 / $464.02 / $724.56
| Professional | | $290.60 | $464.02 | $724.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.32 / $390.61 / $2,872.87
| Facility | | $153.32 | $390.61 | $2,872.87 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $472.30 / $472.30 / $1,320.00
| Facility | 52 | $472.30 | $472.30 | $1,320.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.45 / $565.20 / $1,853.04
| Professional | | $319.45 | $565.20 | $1,853.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.83 / $551.20 / $1,416.99
| Facility | | $283.83 | $551.20 | $1,416.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $283.83 / $464.02 / $664.15
| Professional | | $283.83 | $464.02 | $664.15 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $363.40 / $722.30
| Professional | | $6.00 | $363.40 | $722.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $319.45 / $536.95 / $679.00
| Professional | | $319.45 | $536.95 | $679.00 |