- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.72 / $4,462.74 / $12,765.09
| Facility | | $1,194.72 | $4,462.74 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $67.51 / $67.51 / $127.07
| Facility | 52 | $67.51 | $67.51 | $127.07 |
- 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
- $172.15 / $432.02 / $2,552.80
| Facility | | $172.15 | $432.02 | $2,552.80 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $524.38 / $524.38 / $524.38
| Facility | 52 | $524.38 | $524.38 | $524.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.14 / $598.25 / $1,416.99
| Facility | | $315.14 | $598.25 | $1,416.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |