- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,296.70 / $2,318.00 / $10,985.00
| Facility | | $1,296.70 | $2,318.00 | $10,985.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $648.35 / $648.35 / $1,666.26
| Facility | 52 | $648.35 | $648.35 | $1,666.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,400.00 / $35,883.76 / $50,348.10
| Facility | | $14,400.00 | $35,883.76 | $50,348.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.91 / $1,768.17 / $2,652.26
| Facility | | $1,341.91 | $1,768.17 | $2,652.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,526.00 / $15,288.00 / $23,366.00
| Facility | | $6,526.00 | $15,288.00 | $23,366.00 |