- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $2,568.00 / $6,068.07
| Facility | | $700.00 | $2,568.00 | $6,068.07 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $155.54 / $1,495.47 / $2,583.96
| Facility | 52 | $155.54 | $1,495.47 | $2,583.96 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $79.44 / $155.66 / $590.46
| Facility | 53 | $79.44 | $155.66 | $590.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $175.21 / $303.64 / $616.19
| Professional | | $175.21 | $303.64 | $616.19 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $37.88 / $87.81 / $194.91
| Professional | 53 | $37.88 | $87.81 | $194.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $173.46 / $269.27 / $332.76
| Professional | | $173.46 | $269.27 | $332.76 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $90.53 / $140.44 / $153.47
| Professional | 53 | $90.53 | $140.44 | $153.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.70 / $302.70 / $692.88
| Facility | | $302.70 | $302.70 | $692.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.69 / $3,159.00 / $14,886.03
| Facility | | $2,344.69 | $3,159.00 | $14,886.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $279.76 / $361.60 / $617.01
| Professional | | $279.76 | $361.60 | $617.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.00 / $760.00 / $1,463.23
| Facility | | $429.00 | $760.00 | $1,463.23 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $194.94 / $194.94 / $194.94
| Facility | 52 | $194.94 | $194.94 | $194.94 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $48.74 / $48.74 / $48.74
| Facility | 53 | $48.74 | $48.74 | $48.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.75 / $301.75 / $301.75
| Professional | | $301.75 | $301.75 | $301.75 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $41.90 / $163.72 / $163.72
| Professional | 53 | $41.90 | $163.72 | $163.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.04 / $404.04 / $404.04
| Facility | | $404.04 | $404.04 | $404.04 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $202.40 / $202.40 / $202.40
| Facility | 53 | $202.40 | $202.40 | $202.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $397.70 / $511.33 / $680.43
| Professional | | $397.70 | $511.33 | $680.43 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $198.85 / $243.02 / $336.90
| Professional | 53 | $198.85 | $243.02 | $336.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.04 / $1,819.76 / $3,310.69
| Facility | | $825.04 | $1,819.76 | $3,310.69 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $454.46 / $1,329.60 / $1,708.98
| Facility | 52 | $454.46 | $1,329.60 | $1,708.98 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $2,678.92 / $4,007.95 / $4,764.57
| Facility | 53 | $2,678.92 | $4,007.95 | $4,764.57 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $212.34 / $259.18 / $330.46
| Professional | | $212.34 | $259.18 | $330.46 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $212.34 / $251.09 / $356.39
| Professional | 53 | $212.34 | $251.09 | $356.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.70 / $504.50 / $10,182.00
| Facility | | $302.70 | $504.50 | $10,182.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.86 / $2,202.00 / $5,463.05
| Facility | | $561.86 | $2,202.00 | $5,463.05 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $198.60 / $772.90 / $2,553.96
| Facility | 52 | $198.60 | $772.90 | $2,553.96 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $87.07 / $163.44 / $868.00
| Facility | 53 | $87.07 | $163.44 | $868.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $180.09 / $342.57 / $856.00
| Professional | | $180.09 | $342.57 | $856.00 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $52.13 / $128.86 / $288.33
| Professional | 53 | $52.13 | $128.86 | $288.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.15 / $805.66 / $1,625.30
| Facility | | $776.15 | $805.66 | $1,625.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $156.03 / $475.10 / $858.10
| Professional | | $156.03 | $475.10 | $858.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $243.68 / $760.00 / $1,865.00
| Facility | | $243.68 | $760.00 | $1,865.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $194.94 / $194.94 / $194.94
| Facility | 52 | $194.94 | $194.94 | $194.94 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $48.74 / $48.74 / $48.74
| Facility | 53 | $48.74 | $48.74 | $48.74 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $301.75 / $301.75 / $301.75
| Professional | | $301.75 | $301.75 | $301.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.69 / $329.50 / $437.28
| Facility | | $178.69 | $329.50 | $437.28 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $89.50 / $164.74 / $437.91
| Facility | 53 | $89.50 | $164.74 | $437.91 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $178.69 / $323.22 / $414.85
| Professional | | $178.69 | $323.22 | $414.85 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $89.50 / $161.58 / $284.41
| Professional | 53 | $89.50 | $161.58 | $284.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.00 / $1,090.00 / $3,742.00
| Facility | | $316.00 | $1,090.00 | $3,742.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $289.27 / $414.72 / $661.92
| Professional | | $289.27 | $414.72 | $661.92 |
- Facility/Professional
- Professional
- Modifier
- 53
- Low / Median / High Price
- $204.84 / $204.84 / $204.84
| Professional | 53 | $204.84 | $204.84 | $204.84 |