- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $3,090.30 / $9,120.11
| Facility | | $457.09 | $3,090.30 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | 52 | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,786.30 / $13,489.63
| Facility | | $1,659.59 | $4,786.30 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.15 / $2,630.27 / $9,772.37
| Facility | | $269.15 | $2,630.27 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $331.13 / $331.13 / $331.13
| Facility | 52 | $331.13 | $331.13 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $4,365.16 / $10,471.29
| Facility | | $1,584.89 | $4,365.16 | $10,471.29 |