- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.88 / $4,182.08 / $12,765.09
| Facility | | $1,163.88 | $4,182.08 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $112.48 / $112.48 / $608.74
| Facility | 52 | $112.48 | $112.48 | $608.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,641.59 / $10,356.32 / $19,441.45
| Facility | | $7,641.59 | $10,356.32 | $19,441.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $286.82 / $1,662.66 / $5,457.92
| Facility | | $286.82 | $1,662.66 | $5,457.92 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $869.54 / $869.54 / $869.54
| Facility | 52 | $869.54 | $869.54 | $869.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.24 / $2,389.92 / $3,289.90
| Facility | | $536.24 | $2,389.92 | $3,289.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |