- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,323.00 / $8,169.00 / $31,885.00
| Facility | | $1,323.00 | $8,169.00 | $31,885.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $265.86 / $545.01 / $705.22
| Facility | 52 | $265.86 | $545.01 | $705.22 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $106.34 / $218.00 / $282.08
| Facility | 53 | $106.34 | $218.00 | $282.08 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $530.37 / $699.90 / $2,582.00
| Professional | | $530.37 | $699.90 | $2,582.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $472.22 / $690.26 / $1,523.28
| Professional | | $472.22 | $690.26 | $1,523.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,815.00 / $8,156.00 / $14,362.00
| Facility | | $3,815.00 | $8,156.00 | $14,362.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $581.09 / $755.30 / $1,185.22
| Professional | | $581.09 | $755.30 | $1,185.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,413.00 / $12,909.00 / $22,801.00
| Facility | | $9,413.00 | $12,909.00 | $22,801.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $706.91 / $886.71 / $1,346.03
| Professional | | $706.91 | $886.71 | $1,346.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,792.22 / $39,670.90 / $39,670.90
| Facility | | $4,792.22 | $39,670.90 | $39,670.90 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,018.95 / $30,081.88 / $30,081.88
| Facility | 52 | $1,018.95 | $30,081.88 | $30,081.88 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $254.74 / $7,520.47 / $7,520.47
| Facility | 53 | $254.74 | $7,520.47 | $7,520.47 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $3,571.80 / $3,571.80 / $4,890.89
| Professional | | $3,571.80 | $3,571.80 | $4,890.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $9,163.00 / $26,037.00
| Facility | | $3,964.00 | $9,163.00 | $26,037.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $561.86 / $831.18 / $1,370.83
| Professional | | $561.86 | $831.18 | $1,370.83 |