- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $1,831.00 / $3,057.13
| Facility | | $900.00 | $1,831.00 | $3,057.13 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $630.94 / $630.94 / $1,528.57
| Facility | 52 | $630.94 | $630.94 | $1,528.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,820.00 / $8,820.00 / $9,702.00
| Facility | | $8,820.00 | $8,820.00 | $9,702.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $16,500.00
| Facility | | $1,000.00 | $1,000.00 | $16,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.00 / $8,766.00 / $15,000.00
| Facility | | $1,360.00 | $8,766.00 | $15,000.00 |