- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.43 / $4,182.08 / $12,036.14
| Facility | | $237.43 | $4,182.08 | $12,036.14 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $61.64 / $61.64 / $118.72
| Facility | 52 | $61.64 | $61.64 | $118.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $73.55 / $181.43 / $689.48
| Professional | | $73.55 | $181.43 | $689.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.34 / $145.18 / $290.37
| Professional | | $123.34 | $145.18 | $290.37 |
- 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
- $129.94 / $251.02 / $484.58
| Professional | | $129.94 | $251.02 | $484.58 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $296.06 / $477.36 / $740.15
| Professional | | $296.06 | $477.36 | $740.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.91 / $415.50 / $2,872.87
| Facility | | $184.91 | $415.50 | $2,872.87 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $477.18 / $477.18 / $477.18
| Facility | 52 | $477.18 | $477.18 | $477.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.59 / $590.22 / $6,313.62
| Professional | | $333.59 | $590.22 | $6,313.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.48 / $568.90 / $1,425.85
| Facility | | $298.48 | $568.90 | $1,425.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $286.76 / $477.36 / $682.16
| Professional | | $286.76 | $477.36 | $682.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.00 / $358.50 / $719.00
| Professional | | $6.00 | $358.50 | $719.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,146.67 / $2,930.31 / $7,772.00
| Facility | | $2,146.67 | $2,930.31 | $7,772.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $333.59 / $560.72 / $708.85
| Professional | | $333.59 | $560.72 | $708.85 |