- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.00 / $1,728.00 / $2,377.00
| Facility | | $1,040.00 | $1,728.00 | $2,377.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,176.27 / $1,176.27 / $1,176.27
| Facility | 52 | $1,176.27 | $1,176.27 | $1,176.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,442.51 / $15,062.66 / $20,264.09
| Facility | | $12,442.51 | $15,062.66 | $20,264.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,374.00 / $13,463.00 / $14,084.00
| Facility | | $13,374.00 | $13,463.00 | $14,084.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $6,323.00 / $12,678.00
| Facility | | $1,500.00 | $6,323.00 | $12,678.00 |