- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.32 / $1,383.04 / $10,963.32
| Facility | | $248.32 | $1,383.04 | $10,963.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $124.16 / $691.52 / $691.52
| Facility | 52 | $124.16 | $691.52 | $691.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $207.00 / $1,128.96 / $1,865.47
| Professional | | $207.00 | $1,128.96 | $1,865.47 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $124.16 / $624.12 / $932.74
| Professional | 52 | $124.16 | $624.12 | $932.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,428.23 / $18,247.64 / $38,732.54
| Facility | | $7,428.23 | $18,247.64 | $38,732.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $419.94 / $1,462.43 / $3,968.35
| Professional | | $419.94 | $1,462.43 | $3,968.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,012.07 / $4,273.68 / $10,280.94
| Facility | | $3,012.07 | $4,273.68 | $10,280.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $515.41 / $2,072.61 / $4,982.35
| Professional | | $515.41 | $2,072.61 | $4,982.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,449.86 / $3,907.18 / $8,095.23
| Facility | | $2,449.86 | $3,907.18 | $8,095.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $476.51 / $1,532.77 / $4,328.75
| Professional | | $476.51 | $1,532.77 | $4,328.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $391.94 / $2,337.34 / $14,770.28
| Facility | | $391.94 | $2,337.34 | $14,770.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,590.14 / $3,139.47 / $5,612.64
| Professional | | $1,590.14 | $3,139.47 | $5,612.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $55,151.00
| Facility | | $5,577.00 | $10,743.00 | $55,151.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,358.83 / $2,760.12 / $5,612.64
| Professional | | $1,358.83 | $2,760.12 | $5,612.64 |