- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $2,549.00 / $5,260.00
| Facility | | $860.00 | $2,549.00 | $5,260.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,018.71 / $1,062.02 / $1,792.16
| Facility | 52 | $1,018.71 | $1,062.02 | $1,792.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,961.77 / $25,579.61 / $44,693.19
| Facility | | $12,961.77 | $25,579.61 | $44,693.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,407.80 / $11,054.74 / $11,054.74
| Facility | | $1,407.80 | $11,054.74 | $11,054.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $400.00 / $400.00
| Facility | | $400.00 | $400.00 | $400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.00 / $4,913.00 / $11,696.00
| Facility | | $1,141.00 | $4,913.00 | $11,696.00 |