- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $1,831.00 / $3,322.85
| Facility | | $900.00 | $1,831.00 | $3,322.85 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $685.78 / $685.78 / $1,661.43
| Facility | 52 | $685.78 | $685.78 | $1,661.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,595.00 / $14,595.00 / $16,054.50
| Facility | | $14,595.00 | $14,595.00 | $16,054.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.00 / $9,239.00 / $15,000.00
| Facility | | $1,360.00 | $9,239.00 | $15,000.00 |