- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,386.00 / $2,440.78 / $16,042.00
| Facility | | $1,386.00 | $2,440.78 | $16,042.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $744.08 / $744.08 / $1,220.39
| Facility | 52 | $744.08 | $744.08 | $1,220.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,149.54 / $24,214.00 / $45,778.00
| Facility | | $2,149.54 | $24,214.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,473.14 / $2,021.95 / $3,032.93
| Facility | | $1,473.14 | $2,021.95 | $3,032.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,806.00 / $18,943.00
| Facility | | $4,699.00 | $10,806.00 | $18,943.00 |