- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.93 / $2,906.15 / $6,063.88
| Facility | | $336.93 | $2,906.15 | $6,063.88 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $154.51 / $160.44 / $828.94
| Facility | 52 | $154.51 | $160.44 | $828.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,365.47 / $4,764.46 / $11,246.76
| Facility | | $3,365.47 | $4,764.46 | $11,246.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.32 / $2,655.36 / $6,063.88
| Facility | | $404.32 | $2,655.36 | $6,063.88 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $154.51 / $154.51 / $798.23
| Facility | 52 | $154.51 | $154.51 | $798.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,524.00 / $5,819.00 / $8,339.00
| Facility | | $2,524.00 | $5,819.00 | $8,339.00 |