- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $274.51 / $1,743.25 / $7,182.00
| Facility | | $274.51 | $1,743.25 | $7,182.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $111.49 / $258.58 / $580.34
| Facility | 52 | $111.49 | $258.58 | $580.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.24 / $2,012.12 / $4,036.79
| Facility | | $830.24 | $2,012.12 | $4,036.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,048.92 / $2,632.90
| Facility | | $505.00 | $2,048.92 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $222.98 / $457.77 / $961.91
| Facility | | $222.98 | $457.77 | $961.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |