- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,644.27
| Facility | | $1,000.00 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $814.92 / $814.92 / $814.92
| Facility | 52 | $814.92 | $814.92 | $814.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,613.74 / $49,918.88 / $75,059.84
| Facility | | $13,613.74 | $49,918.88 | $75,059.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.80 / $1,775.58 / $2,440.27
| Facility | | $1,457.80 | $1,775.58 | $2,440.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $899.00 / $11,259.00 / $16,897.00
| Facility | | $899.00 | $11,259.00 | $16,897.00 |