- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.34 / $3,030.50 / $7,633.72
| Facility | | $497.34 | $3,030.50 | $7,633.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $130.55 / $206.86 / $811.42
| Facility | 52 | $130.55 | $206.86 | $811.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,945.58 / $10,517.23
| Facility | | $3,283.00 | $4,945.58 | $10,517.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,034.21 / $2,041.52 / $2,234.79
| Facility | | $2,034.21 | $2,041.52 | $2,234.79 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $329.71 / $329.71 / $329.71
| Facility | 52 | $329.71 | $329.71 | $329.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,981.00 / $3,951.00 / $7,934.00
| Facility | | $1,981.00 | $3,951.00 | $7,934.00 |