- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.88 / $5,727.00 / $11,576.00
| Facility | | $203.88 | $5,727.00 | $11,576.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $92.26 / $99.61 / $101.94
| Facility | 52 | $92.26 | $99.61 | $101.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $323.00 / $323.00
| Facility | | $323.00 | $323.00 | $323.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,460.00 / $21,065.00 / $32,051.00
| Facility | | $9,460.00 | $21,065.00 | $32,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $677.00 / $5,350.00 / $13,093.00
| Facility | | $677.00 | $5,350.00 | $13,093.00 |