- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $278.14 / $3,084.00 / $8,014.30
| Facility | | $278.14 | $3,084.00 | $8,014.30 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $139.08 / $139.08 / $502.10
| Facility | 52 | $139.08 | $139.08 | $502.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $216.37 / $931.89 / $3,154.53
| Professional | | $216.37 | $931.89 | $3,154.53 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $305.33 / $1,142.04 / $2,607.82
| Professional | | $305.33 | $1,142.04 | $2,607.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $783.66 / $997.17 / $1,277.93
| Professional | | $783.66 | $997.17 | $1,277.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,209.35 / $7,100.42 / $10,347.35
| Facility | | $5,209.35 | $7,100.42 | $10,347.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.86 / $661.50 / $1,793.79
| Professional | | $311.86 | $661.50 | $1,793.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,613.00 / $7,048.00
| Facility | | $1,981.00 | $3,613.00 | $7,048.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $874.14 / $1,169.29 / $2,319.35
| Professional | | $874.14 | $1,169.29 | $2,319.35 |