- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.89 / $1,532.00 / $6,097.00
| Facility | | $352.89 | $1,532.00 | $6,097.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $100.11 / $2,117.46 / $8,991.00
| Facility | 52 | $100.11 | $2,117.46 | $8,991.00 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $40.04 / $40.04 / $88.18
| Facility | 53 | $40.04 | $40.04 | $88.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $200.22 / $440.88 / $818.84
| Professional | | $200.22 | $440.88 | $818.84 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $100.11 / $199.21 / $328.40
| Professional | 52 | $100.11 | $199.21 | $328.40 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $39.71 / $78.64 / $121.61
| Professional | 53 | $39.71 | $78.64 | $121.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,434.00 / $5,082.00 / $9,729.00
| Facility | | $3,434.00 | $5,082.00 | $9,729.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $226.41 / $298.49 / $424.10
| Professional | | $226.41 | $298.49 | $424.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.16 / $800.00 / $2,213.00
| Facility | | $338.16 | $800.00 | $2,213.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $270.52 / $270.52 / $270.52
| Facility | 52 | $270.52 | $270.52 | $270.52 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $67.63 / $67.63 / $67.63
| Facility | 53 | $67.63 | $67.63 | $67.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $258.35 / $438.79 / $773.46
| Professional | | $258.35 | $438.79 | $773.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.99 / $440.88 / $707.60
| Facility | | $216.99 | $440.88 | $707.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $252.69 / $470.84 / $749.07
| Professional | | $252.69 | $470.84 | $749.07 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $326.56 / $326.56 / $719.11
| Professional | 53 | $326.56 | $326.56 | $719.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,463.00 / $2,155.00 / $5,513.00
| Facility | | $1,463.00 | $2,155.00 | $5,513.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $470.82 / $650.84 / $1,264.46
| Professional | | $470.82 | $650.84 | $1,264.46 |