- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $743.00 / $2,703.75 / $7,493.26
| Facility | | $743.00 | $2,703.75 | $7,493.26 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,866.00 / $4,833.77 / $7,108.56
| Facility | 50 | $1,866.00 | $4,833.77 | $7,108.56 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $74.50 / $210.86 / $599.29
| Facility | 52 | $74.50 | $210.86 | $599.29 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $29.80 / $84.34 / $239.72
| Facility | 53 | $29.80 | $84.34 | $239.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $149.00 / $415.97 / $812.64
| Professional | | $149.00 | $415.97 | $812.64 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $212.00 / $609.92 / $1,547.22
| Professional | 50 | $212.00 | $609.92 | $1,547.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,917.00 / $3,611.00 / $5,959.00
| Facility | | $1,917.00 | $3,611.00 | $5,959.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.10 / $396.90 / $882.07
| Professional | | $157.10 | $396.90 | $882.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $174.33 / $363.27 / $841.87
| Professional | | $174.33 | $363.27 | $841.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.52 / $969.57 / $16,394.00
| Facility | | $718.52 | $969.57 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $606.59 / $606.59 / $775.66
| Facility | 52 | $606.59 | $606.59 | $775.66 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $151.65 / $151.65 / $193.91
| Facility | 53 | $151.65 | $151.65 | $193.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,561.00 / $4,715.39 / $4,871.00
| Professional | | $1,561.00 | $4,715.39 | $4,871.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,695.00 / $3,616.00 / $6,285.00
| Facility | | $1,695.00 | $3,616.00 | $6,285.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.22 / $676.63 / $1,032.56
| Professional | | $425.22 | $676.63 | $1,032.56 |