- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $733.05 / $2,899.52 / $6,063.98
| Facility | | $733.05 | $2,899.52 | $6,063.98 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $117.08 / $117.08 / $220.25
| Facility | 52 | $117.08 | $117.08 | $220.25 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $46.83 / $46.83 / $88.10
| Facility | 53 | $46.83 | $46.83 | $88.10 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $234.16 / $519.64 / $1,869.89
| Professional | | $234.16 | $519.64 | $1,869.89 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $42.33 / $78.53 / $89.52
| Professional | 53 | $42.33 | $78.53 | $89.52 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $416.15 / $710.43 / $1,293.31
| Professional | | $416.15 | $710.43 | $1,293.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.72 / $714.67 / $2,000.00
| Facility | | $331.72 | $714.67 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $506.57 / $883.37 / $3,439.23
| Professional | | $506.57 | $883.37 | $3,439.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.27 / $991.26 / $1,442.22
| Facility | | $598.27 | $991.26 | $1,442.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $546.57 / $914.52 / $1,187.96
| Professional | | $546.57 | $914.52 | $1,187.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $412.97 / $619.00 / $870.73
| Professional | | $412.97 | $619.00 | $870.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,000.00 / $2,000.00
| Facility | | $2,000.00 | $2,000.00 | $2,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $524.44 / $828.46 / $1,247.08
| Professional | | $524.44 | $828.46 | $1,247.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $482.00 / $589.70 / $1,056.90
| Professional | | $482.00 | $589.70 | $1,056.90 |