- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.28 / $4,241.22 / $12,765.09
| Facility | | $859.28 | $4,241.22 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $85.71 / $85.71 / $211.01
| Facility | 52 | $85.71 | $85.71 | $211.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,616.14 / $6,256.05 / $11,744.20
| Facility | | $4,616.14 | $6,256.05 | $11,744.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.13 / $717.43 / $5,641.00
| Facility | | $257.13 | $717.43 | $5,641.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $664.86 / $664.86 / $664.86
| Facility | 52 | $664.86 | $664.86 | $664.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.30 / $1,016.05 / $2,860.34
| Facility | | $441.30 | $1,016.05 | $2,860.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |