- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.48 / $3,908.01 / $13,841.56
| Facility | | $362.48 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,011.00 / $1,011.00 / $1,011.00
| Facility | 52 | $1,011.00 | $1,011.00 | $1,011.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.69 / $362.48 / $1,203.20
| Professional | | $135.69 | $362.48 | $1,203.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Low / Median / High Price
- $203.55 / $203.55 / $203.55
| Professional | 50 | $203.55 | $203.55 | $203.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,973.60 / $6,541.64 / $12,653.65
| Facility | | $4,973.60 | $6,541.64 | $12,653.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $144.06 / $327.43 / $736.66
| Professional | | $144.06 | $327.43 | $736.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.58 / $558.00 / $1,121.90
| Professional | | $285.58 | $558.00 | $1,121.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.06 / $408.86 / $1,020.74
| Facility | | $156.06 | $408.86 | $1,020.74 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $534.08 / $534.08 / $1,213.20
| Facility | 52 | $534.08 | $534.08 | $1,213.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $496.99 / $834.05 / $1,095.68
| Professional | | $496.99 | $834.05 | $1,095.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.40 / $901.86 / $1,750.65
| Facility | | $345.40 | $901.86 | $1,750.65 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $320.95 / $725.72 / $1,189.07
| Professional | | $320.95 | $725.72 | $1,189.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $459.32 / $821.95 / $1,008.51
| Professional | | $459.32 | $821.95 | $1,008.51 |