- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.69 / $1,218.00 / $3,109.00
| Facility | | $212.69 | $1,218.00 | $3,109.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $97.91 / $132.79 / $202.10
| Facility | 52 | $97.91 | $132.79 | $202.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,625.78 / $1,625.78 / $1,950.94
| Facility | | $1,625.78 | $1,625.78 | $1,950.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.78 / $206.78 / $206.78
| Facility | | $206.78 | $206.78 | $206.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,046.51 / $1,046.51 / $1,046.51
| Facility | | $1,046.51 | $1,046.51 | $1,046.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.00 / $1,230.00 / $2,539.00
| Facility | | $590.00 | $1,230.00 | $2,539.00 |