- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,896.22 / $4,778.89 / $13,841.56
| Facility | | $1,896.22 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $151.83 / $151.83 / $151.83
| Facility | 52 | $151.83 | $151.83 | $151.83 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $60.73 / $60.73 / $60.73
| Facility | 53 | $60.73 | $60.73 | $60.73 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $303.66 / $472.50 / $999.05
| Professional | | $303.66 | $472.50 | $999.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $606.14 / $606.14 / $606.14
| Professional | | $606.14 | $606.14 | $606.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,685.60 / $5,343.09 / $9,376.78
| Facility | | $3,685.60 | $5,343.09 | $9,376.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $292.52 / $498.63 / $664.83
| Professional | | $292.52 | $498.63 | $664.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $395.61 / $757.56 / $1,022.64
| Professional | | $395.61 | $757.56 | $1,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.66 / $516.22 / $3,044.00
| Facility | | $303.66 | $516.22 | $3,044.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $6,012.68 / $6,012.68 / $6,012.68
| Facility | 52 | $6,012.68 | $6,012.68 | $6,012.68 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $1,503.17 / $1,503.17 / $1,503.17
| Facility | 53 | $1,503.17 | $1,503.17 | $1,503.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.11 / $718.92 / $2,445.36
| Professional | | $480.11 | $718.92 | $2,445.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.60 / $812.51 / $2,630.67
| Facility | | $609.60 | $812.51 | $2,630.67 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $521.82 / $784.09 / $1,012.60
| Professional | | $521.82 | $784.09 | $1,012.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $4.00 / $539.90 / $658.85
| Professional | | $4.00 | $539.90 | $658.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $480.11 / $746.08 / $792.81
| Professional | | $480.11 | $746.08 | $792.81 |