- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.78 / $1,616.46 / $10,985.00
| Facility | | $119.78 | $1,616.46 | $10,985.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $675.47 / $675.47 / $1,110.50
| Facility | 52 | $675.47 | $675.47 | $1,110.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,168.00 / $35,293.60 / $50,348.10
| Facility | | $14,168.00 | $35,293.60 | $50,348.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,396.34 / $1,839.88 / $2,759.82
| Facility | | $1,396.34 | $1,839.88 | $2,759.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,526.00 / $15,288.00 / $23,366.00
| Facility | | $6,526.00 | $15,288.00 | $23,366.00 |