- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.83 / $1,544.00 / $6,012.00
| Facility | | $213.83 | $1,544.00 | $6,012.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $76.12 / $76.12 / $148.10
| Facility | 52 | $76.12 | $76.12 | $148.10 |
- 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
- $965.14 / $3,303.84 / $5,488.46
| Facility | | $965.14 | $3,303.84 | $5,488.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.19 / $2,180.00 / $7,799.00
| Facility | | $296.19 | $2,180.00 | $7,799.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $76.12 / $76.12 / $148.10
| Facility | 52 | $76.12 | $76.12 | $148.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.61 / $165.59 / $263.33
| Facility | | $141.61 | $165.59 | $263.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $814.00 / $2,391.00 / $4,789.00
| Facility | | $814.00 | $2,391.00 | $4,789.00 |