- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.00 / $2,581.76 / $4,806.64
| Facility | | $699.00 | $2,581.76 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $56.68 / $56.68 / $126.44
| Facility | 52 | $56.68 | $56.68 | $126.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.09 / $252.88 / $699.00
| Professional | | $4.09 | $252.88 | $699.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.35 / $2,948.45 / $10,821.00
| Facility | | $316.35 | $2,948.45 | $10,821.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $514.26 / $514.26 / $514.26
| Facility | 52 | $514.26 | $514.26 | $514.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.26 / $403.71 / $6,313.62
| Professional | | $165.26 | $403.71 | $6,313.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.28 / $195.36 / $383.21
| Facility | | $150.28 | $195.36 | $383.21 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.25 / $392.80 / $639.29
| Professional | | $216.25 | $392.80 | $639.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.97 / $406.38 / $805.59
| Professional | | $204.97 | $406.38 | $805.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.01 / $300.00 / $6,679.00
| Facility | | $132.01 | $300.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $294.61 / $372.27 / $665.60
| Professional | | $294.61 | $372.27 | $665.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $165.41 / $357.46 / $695.65
| Professional | | $165.41 | $357.46 | $695.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.47 / $1,640.09 / $3,437.28
| Facility | | $785.47 | $1,640.09 | $3,437.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $139.21 / $210.62 / $463.01
| Professional | | $139.21 | $210.62 | $463.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.33 / $3,649.00 / $16,394.00
| Facility | | $1,051.33 | $3,649.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $514.26 / $514.26 / $514.26
| Facility | 52 | $514.26 | $514.26 | $514.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $334.25 / $663.39 / $6,313.62
| Professional | | $334.25 | $663.39 | $6,313.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,640.00 / $3,592.00 / $8,425.00
| Facility | | $1,640.00 | $3,592.00 | $8,425.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $326.52 / $493.43 / $806.99
| Professional | | $326.52 | $493.43 | $806.99 |