- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58.62 / $132.56 / $2,042.00
| Facility | | $58.62 | $132.56 | $2,042.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $29.31 / $66.28 / $66.28
| Facility | 52 | $29.31 | $66.28 | $66.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $58.62 / $137.88 / $726.75
| Professional | | $58.62 | $137.88 | $726.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $337.44 / $1,189.15 / $2,457.60
| Facility | | $337.44 | $1,189.15 | $2,457.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $123.34 / $245.09 / $499.54
| Professional | | $123.34 | $245.09 | $499.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $359.46 / $510.02 / $1,226.93
| Facility | | $359.46 | $510.02 | $1,226.93 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $88.22 / $88.22 / $88.22
| Facility | 52 | $88.22 | $88.22 | $88.22 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $127.85 / $256.26 / $583.52
| Professional | | $127.85 | $256.26 | $583.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.37 / $466.28 / $966.09
| Facility | | $292.37 | $466.28 | $966.09 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $126.59 / $240.72 / $495.30
| Professional | | $126.59 | $240.72 | $495.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.04 / $187.88 / $1,136.00
| Facility | | $81.04 | $187.88 | $1,136.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $233.74 / $233.74 / $233.74
| Facility | 52 | $233.74 | $233.74 | $233.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.61 / $298.02 / $568.83
| Professional | | $157.61 | $298.02 | $568.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $2,872.00 / $4,241.00
| Facility | | $1,187.00 | $2,872.00 | $4,241.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.61 / $282.52 / $537.05
| Professional | | $157.61 | $282.52 | $537.05 |