- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,244.30 / $2,330.61 / $7,069.55
| Facility | | $2,244.30 | $2,330.61 | $7,069.55 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,122.15 / $12,424.40 / $12,424.40
| Facility | 52 | $1,122.15 | $12,424.40 | $12,424.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,606.61 / $20,664.98 / $27,997.76
| Facility | | $17,606.61 | $20,664.98 | $27,997.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,834.66 / $2,399.63 / $8,060.00
| Facility | | $1,834.66 | $2,399.63 | $8,060.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,122.15 / $12,424.40 / $12,424.40
| Facility | 52 | $1,122.15 | $12,424.40 | $12,424.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $11,464.00 / $14,085.00
| Facility | | $4,699.00 | $11,464.00 | $14,085.00 |