- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.56 / $2,747.00 / $10,632.00
| Facility | | $373.56 | $2,747.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $156.99 / $175.78 / $186.78
| Facility | 52 | $156.99 | $175.78 | $186.78 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $235.48 / $263.67 / $280.17
| Facility | 54 | $235.48 | $263.67 | $280.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.73 / $128.77 / $323.00
| Facility | | $126.73 | $128.77 | $323.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,438.00 / $2,403.00 / $4,241.00
| Facility | | $1,438.00 | $2,403.00 | $4,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $366.00 / $1,950.00 / $5,107.00
| Facility | | $366.00 | $1,950.00 | $5,107.00 |