- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.40 / $3,825.98 / $9,727.00
| Facility | | $501.40 | $3,825.98 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $146.43 / $340.20 / $1,162.04
| Facility | 52 | $146.43 | $340.20 | $1,162.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.32 / $2,187.00 / $4,035.45
| Facility | | $1,090.32 | $2,187.00 | $4,035.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,048.92 / $2,048.92 / $2,632.90
| Facility | | $2,048.92 | $2,048.92 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.86 / $1,267.63 / $2,074.40
| Facility | | $292.86 | $1,267.63 | $2,074.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |