- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.87 / $3,716.69 / $8,531.36
| Facility | | $531.87 | $3,716.69 | $8,531.36 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,866.00 / $4,899.00 / $8,530.58
| Facility | 50 | $1,866.00 | $4,899.00 | $8,530.58 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $80.18 / $144.74 / $320.13
| Facility | 52 | $80.18 | $144.74 | $320.13 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $31.86 / $53.48 / $126.98
| Facility | 53 | $31.86 | $53.48 | $126.98 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $150.46 / $350.91 / $780.17
| Professional | | $150.46 | $350.91 | $780.17 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $139.72 / $538.39 / $1,028.00
| Professional | 50 | $139.72 | $538.39 | $1,028.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $5,786.00 / $11,593.00
| Facility | | $3,283.00 | $5,786.00 | $11,593.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $183.25 / $361.06 / $763.06
| Professional | | $183.25 | $361.06 | $763.06 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $276.25 / $536.86 / $1,017.74
| Professional | 50 | $276.25 | $536.86 | $1,017.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,745.52 / $2,353.44 / $3,438.00
| Facility | | $1,745.52 | $2,353.44 | $3,438.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $210.86 / $210.86 / $210.86
| Facility | 52 | $210.86 | $210.86 | $210.86 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $52.72 / $52.72 / $52.72
| Facility | 53 | $52.72 | $52.72 | $52.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $177.27 / $394.38 / $887.54
| Professional | | $177.27 | $394.38 | $887.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.22 / $648.27 / $1,047.82
| Professional | | $425.22 | $648.27 | $1,047.82 |