- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.07 / $344.76 / $5,719.95
| Facility | | $135.07 | $344.76 | $5,719.95 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $27.01 / $68.95 / $68.95
| Facility | 53 | $27.01 | $68.95 | $68.95 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.07 / $280.14 / $1,320.00
| Professional | | $135.07 | $280.14 | $1,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,978.00 / $6,373.77 / $11,110.48
| Facility | | $2,978.00 | $6,373.77 | $11,110.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $275.57 / $566.02 / $1,233.49
| Professional | | $275.57 | $566.02 | $1,233.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.91 / $1,280.43 / $3,080.26
| Facility | | $902.91 | $1,280.43 | $3,080.26 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $350.15 / $673.40 / $1,441.62
| Professional | | $350.15 | $673.40 | $1,441.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.00 / $1,170.61 / $2,425.40
| Facility | | $734.00 | $1,170.61 | $2,425.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $311.37 / $580.91 / $1,252.50
| Professional | | $311.37 | $580.91 | $1,252.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.67 / $578.91 / $5,360.94
| Facility | | $248.67 | $578.91 | $5,360.94 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.18 / $906.12 / $1,741.91
| Professional | | $398.18 | $906.12 | $1,741.91 |
- 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
- $374.57 / $785.09 / $1,314.76
| Professional | | $374.57 | $785.09 | $1,314.76 |