- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,690.21 / $6,173.48 / $8,522.34
| Facility | | $1,690.21 | $6,173.48 | $8,522.34 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $105.48 / $105.48 / $338.04
| Facility | 53 | $105.48 | $105.48 | $338.04 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $309.42 / $697.27 / $2,267.81
| Professional | | $309.42 | $697.27 | $2,267.81 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $455.10 / $1,376.59 / $1,774.93
| Professional | | $455.10 | $1,376.59 | $1,774.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $82.48 / $670.28 / $916.32
| Professional | | $82.48 | $670.28 | $916.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,735.70 / $6,043.65 / $8,807.33
| Facility | | $4,735.70 | $6,043.65 | $8,807.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $474.31 / $1,250.61 / $2,638.48
| Professional | | $474.31 | $1,250.61 | $2,638.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.00 / $6,097.00 / $11,487.00
| Facility | | $1,202.00 | $6,097.00 | $11,487.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $887.69 / $1,237.21 / $2,271.12
| Professional | | $887.69 | $1,237.21 | $2,271.12 |