- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.16 / $5,000.27 / $7,838.38
| Facility | | $597.16 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $298.58 / $298.58 / $298.58
| Facility | 52 | $298.58 | $298.58 | $298.58 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $447.88 / $447.88 / $447.88
| Facility | 54 | $447.88 | $447.88 | $447.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,546.18 / $5,354.03 / $8,308.17
| Facility | | $1,546.18 | $5,354.03 | $8,308.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $535.54 / $682.04 / $872.38
| Facility | | $535.54 | $682.04 | $872.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $559.00 / $3,503.00 / $5,060.00
| Facility | | $559.00 | $3,503.00 | $5,060.00 |