- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,415.00 / $7,655.00 / $18,600.00
| Facility | | $2,415.00 | $7,655.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $886.48 / $886.48 / $1,149.54
| Facility | 52 | $886.48 | $886.48 | $1,149.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,477.32 / $15,672.94 / $16,456.59
| Facility | | $13,477.32 | $15,672.94 | $16,456.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,313.63 / $2,206.32 / $10,268.00
| Facility | | $1,313.63 | $2,206.32 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,894.00 / $10,300.00 / $24,722.00
| Facility | | $2,894.00 | $10,300.00 | $24,722.00 |