- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.41 / $2,669.55 / $7,212.00
| Facility | | $256.41 | $2,669.55 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $91.23 / $222.51 / $303.33
| Facility | 52 | $91.23 | $222.51 | $303.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $5,570.00 / $13,810.27
| Facility | | $2,266.00 | $5,570.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.46 / $218.53 / $557.01
| Facility | | $171.46 | $218.53 | $557.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,158.09 / $2,158.09 / $2,158.09
| Facility | | $2,158.09 | $2,158.09 | $2,158.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |