- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $3,166.00 / $8,017.00
| Facility | | $918.00 | $3,166.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $142.78 / $149.94 / $149.94
| Facility | 52 | $142.78 | $149.94 | $149.94 |
- 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 / $2,656.00 / $11,595.96
| Facility | | $491.00 | $2,656.00 | $11,595.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $254.41 / $254.41 / $254.41
| Facility | 52 | $254.41 | $254.41 | $254.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.21 / $627.21 / $627.21
| Facility | | $627.21 | $627.21 | $627.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,192.87 / $11,192.87 / $11,192.87
| Facility | | $11,192.87 | $11,192.87 | $11,192.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $943.00 / $3,077.00 / $8,017.00
| Facility | | $943.00 | $3,077.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $149.94 / $149.94 / $149.94
| Facility | 52 | $149.94 | $149.94 | $149.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.60 / $329.60 / $329.60
| Facility | | $329.60 | $329.60 | $329.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.48 / $2,109.00 / $11,034.22
| Facility | | $325.48 | $2,109.00 | $11,034.22 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $254.41 / $254.41 / $254.41
| Facility | 52 | $254.41 | $254.41 | $254.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $280.36 / $280.36 / $334.82
| Facility | | $280.36 | $280.36 | $334.82 |
- 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 |