- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,694.00 / $5,432.00
| Facility | | $900.00 | $2,694.00 | $5,432.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $884.25 / $920.87 / $1,553.97
| Facility | 52 | $884.25 | $920.87 | $1,553.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,399.67 / $18,824.54 / $28,184.08
| Facility | | $10,399.67 | $18,824.54 | $28,184.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $1,244.46
| Facility | | $40.00 | $40.00 | $1,244.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $400.00 / $400.00
| Facility | | $400.00 | $400.00 | $400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,215.00 / $9,403.00 / $23,200.00
| Facility | | $1,215.00 | $9,403.00 | $23,200.00 |