- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.82 / $4,022.00 / $10,086.00
| Facility | | $371.82 | $4,022.00 | $10,086.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $78.34 / $124.87 / $240.16
| Facility | 52 | $78.34 | $124.87 | $240.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.00 / $1,605.10 / $1,910.83
| Facility | | $432.00 | $1,605.10 | $1,910.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,759.00 / $23,031.00
| Facility | | $5,979.00 | $12,759.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,637.00 / $8,136.00 / $12,748.00
| Facility | | $2,637.00 | $8,136.00 | $12,748.00 |