- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.48 / $8,419.00 / $20,453.00
| Facility | | $1,457.48 | $8,419.00 | $20,453.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $728.74 / $728.74 / $4,822.50
| Facility | 52 | $728.74 | $728.74 | $4,822.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,500.00 / $20,323.00 / $21,225.00
| Facility | | $10,500.00 | $20,323.00 | $21,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,571.00 / $9,571.00 / $9,571.00
| Facility | | $9,571.00 | $9,571.00 | $9,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,066.00 / $13,781.00 / $27,214.00
| Facility | | $6,066.00 | $13,781.00 | $27,214.00 |