- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.27 / $3,735.40 / $5,756.98
| Facility | | $282.27 | $3,735.40 | $5,756.98 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $141.13 / $141.13 / $141.13
| Facility | 52 | $141.13 | $141.13 | $141.13 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $56.46 / $56.46 / $56.46
| Facility | 53 | $56.46 | $56.46 | $56.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $282.27 / $341.52 / $1,562.00
| Professional | | $282.27 | $341.52 | $1,562.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,211.87 / $5,677.23 / $12,389.06
| Facility | | $2,211.87 | $5,677.23 | $12,389.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $500.35 / $774.59 / $1,087.41
| Professional | | $500.35 | $774.59 | $1,087.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.08 / $1,014.08 / $2,439.50
| Facility | | $715.08 | $1,014.08 | $2,439.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.23 / $977.70 / $1,394.45
| Professional | | $581.23 | $977.70 | $1,394.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.30 / $927.11 / $1,920.86
| Facility | | $581.30 | $927.11 | $1,920.86 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $511.72 / $875.70 / $1,160.49
| Professional | | $511.72 | $875.70 | $1,160.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $447.35 / $848.58 / $6,740.00
| Facility | | $447.35 | $848.58 | $6,740.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,551.50 / $2,551.50 / $2,551.50
| Facility | 50 | $2,551.50 | $2,551.50 | $2,551.50 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.21 / $783.29 / $1,572.52
| Professional | | $399.21 | $783.29 | $1,572.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $399.21 / $785.51 / $1,213.34
| Professional | | $399.21 | $785.51 | $1,213.34 |