- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.26 / $3,090.31 / $9,529.70
| Facility | | $369.26 | $3,090.31 | $9,529.70 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $96.68 / $96.68 / $251.67
| Facility | 52 | $96.68 | $96.68 | $251.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.00 / $4,444.00 / $15,949.31
| Facility | | $3,736.00 | $4,444.00 | $15,949.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.25 / $14,110.09 / $31,028.69
| Facility | | $1,636.25 | $14,110.09 | $31,028.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.63 / $3,032.00 / $13,963.07
| Facility | | $408.63 | $3,032.00 | $13,963.07 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $96.68 / $96.68 / $251.67
| Facility | 52 | $96.68 | $96.68 | $251.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $179.87 / $435.97 / $741.82
| Facility | | $179.87 | $435.97 | $741.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,475.00 / $6,000.00
| Facility | | $2,155.00 | $3,475.00 | $6,000.00 |