- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.00 / $2,938.00 / $7,799.00
| Facility | | $316.00 | $2,938.00 | $7,799.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $129.32 / $135.77 / $135.77
| Facility | 52 | $129.32 | $135.77 | $135.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.00 / $1,235.59 / $2,760.00
| Facility | | $491.00 | $1,235.59 | $2,760.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $230.55 / $230.55 / $230.55
| Facility | 52 | $230.55 | $230.55 | $230.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $569.91 / $569.91 / $569.91
| Facility | | $569.91 | $569.91 | $569.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,151.97 / $5,151.97 / $10,644.98
| Facility | | $5,151.97 | $5,151.97 | $10,644.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.00 / $3,839.00 / $8,017.00
| Facility | | $760.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $135.77 / $135.77 / $135.77
| Facility | 52 | $135.77 | $135.77 | $135.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.80 / $296.80 / $296.80
| Facility | | $296.80 | $296.80 | $296.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.83 / $1,225.90 / $3,025.00
| Facility | | $294.83 | $1,225.90 | $3,025.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $230.55 / $230.55 / $230.55
| Facility | 52 | $230.55 | $230.55 | $230.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.69 / $253.69 / $301.86
| Facility | | $253.69 | $253.69 | $301.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.00 / $1,734.00 / $4,300.00
| Facility | | $550.00 | $1,734.00 | $4,300.00 |