- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $374.76 / $2,513.75 / $6,310.81
| Facility | | $374.76 | $2,513.75 | $6,310.81 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $99.92 / $154.05 / $326.74
| Facility | 52 | $99.92 | $154.05 | $326.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $5,125.66 / $9,678.00
| Facility | | $2,266.00 | $5,125.66 | $9,678.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,694.29 / $2,034.12 / $2,632.90
| Facility | | $1,694.29 | $2,034.12 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $251.83 / $251.83 / $251.83
| Facility | 52 | $251.83 | $251.83 | $251.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $5,735.00 / $9,622.00
| Facility | | $2,637.00 | $5,735.00 | $9,622.00 |