- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.76 / $2,418.02 / $7,796.00
| Facility | | $324.76 | $2,418.02 | $7,796.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $87.75 / $162.38 / $347.28
| Facility | 52 | $87.75 | $162.38 | $347.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.93 / $2,340.64 / $4,036.79
| Facility | | $801.93 | $2,340.64 | $4,036.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $1,007.90 / $1,295.17
| Facility | | $375.00 | $1,007.90 | $1,295.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.50 / $321.02 / $479.40
| Facility | | $175.50 | $321.02 | $479.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |