- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.46 / $3,276.00 / $10,632.00
| Facility | | $517.46 | $3,276.00 | $10,632.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $232.92 / $258.58 / $258.73
| Facility | 52 | $232.92 | $258.58 | $258.73 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $349.38 / $387.89 / $388.10
| Facility | 54 | $349.38 | $387.89 | $388.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $835.58 / $994.74
| Facility | | $432.00 | $835.58 | $994.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $4,823.00 / $9,635.00
| Facility | | $2,578.00 | $4,823.00 | $9,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $3,611.00 / $8,105.00
| Facility | | $1,014.00 | $3,611.00 | $8,105.00 |