- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.98 / $2,330.00 / $7,365.00
| Facility | | $77.98 | $2,330.00 | $7,365.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $24.16 / $38.21 / $49.30
| Facility | 52 | $24.16 | $38.21 | $49.30 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $9.66 / $15.28 / $19.72
| Facility | 53 | $9.66 | $15.28 | $19.72 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $60.00 / $110.89 / $282.17
| Professional | | $60.00 | $110.89 | $282.17 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $29.12 / $39.00 / $69.19
| Professional | 52 | $29.12 | $39.00 | $69.19 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $11.65 / $19.04 / $38.13
| Professional | 53 | $11.65 | $19.04 | $38.13 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $89.99 / $126.48 / $148.80
| Professional | | $89.99 | $126.48 | $148.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $78.94 / $110.19 / $176.40
| Professional | | $78.94 | $110.19 | $176.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $71.97 / $134.68 / $235.35
| Professional | | $71.97 | $134.68 | $235.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $122.87 / $747.00
| Facility | | $55.00 | $122.87 | $747.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $228.87 / $228.87 / $228.87
| Facility | 52 | $228.87 | $228.87 | $228.87 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $57.22 / $57.22 / $57.22
| Facility | 53 | $57.22 | $57.22 | $57.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $106.77 / $177.90 / $753.20
| Professional | | $106.77 | $177.90 | $753.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.00 / $747.00 / $1,300.00
| Facility | | $176.00 | $747.00 | $1,300.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $101.05 / $139.13 / $259.81
| Professional | | $101.05 | $139.13 | $259.81 |