- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $248.21 / $1,433.51 / $8,422.60
| Facility | | $248.21 | $1,433.51 | $8,422.60 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $124.11 / $716.76 / $716.76
| Facility | 52 | $124.11 | $716.76 | $716.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.04 / $5,890.92 / $13,308.42
| Facility | | $1,154.04 | $5,890.92 | $13,308.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,284.83 / $4,658.30 / $11,206.16
| Facility | | $3,284.83 | $4,658.30 | $11,206.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.33 / $4,258.80 / $8,823.75
| Facility | | $2,670.33 | $4,258.80 | $8,823.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $404.26 / $2,242.02 / $7,573.23
| Facility | | $404.26 | $2,242.02 | $7,573.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |