- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $892.00 / $1,831.00 / $3,519.76
| Facility | | $892.00 | $1,831.00 | $3,519.76 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $726.42 / $726.42 / $1,759.88
| Facility | 52 | $726.42 | $726.42 | $1,759.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,009.59 / $12,009.59 / $12,009.59
| Facility | | $12,009.59 | $12,009.59 | $12,009.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $21,000.00
| Facility | | $1,000.00 | $1,000.00 | $21,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.00 / $4,193.00 / $10,251.00
| Facility | | $985.00 | $4,193.00 | $10,251.00 |