- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $5,350.00 / $9,960.29
| Facility | | $1,020.00 | $5,350.00 | $9,960.29 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $134.86 / $134.86 / $4,157.64
| Facility | 52 | $134.86 | $134.86 | $4,157.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,150.00 / $7,567.00 / $11,091.00
| Facility | | $4,150.00 | $7,567.00 | $11,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.00 / $1,993.85 / $3,928.61
| Facility | | $606.00 | $1,993.85 | $3,928.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $232.05 / $232.05 / $232.05
| Facility | 52 | $232.05 | $232.05 | $232.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.97 / $578.97 / $578.97
| Facility | | $578.97 | $578.97 | $578.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.72 / $7,270.53 / $13,499.14
| Facility | | $3,000.72 | $7,270.53 | $13,499.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.06 / $5,497.30 / $10,070.43
| Facility | | $801.06 | $5,497.30 | $10,070.43 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $134.86 / $2,683.55 / $4,157.64
| Facility | 52 | $134.86 | $2,683.55 | $4,157.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.80 / $5,366.50 / $5,366.50
| Facility | | $326.80 | $5,366.50 | $5,366.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $290.89 / $1,978.20 / $3,738.29
| Facility | | $290.89 | $1,978.20 | $3,738.29 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $232.05 / $232.05 / $232.05
| Facility | 52 | $232.05 | $232.05 | $232.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.14 / $251.14 / $337.62
| Facility | | $251.14 | $251.14 | $337.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.00 / $2,715.00 / $4,815.00
| Facility | | $825.00 | $2,715.00 | $4,815.00 |