- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.72 / $3,839.00 / $8,427.00
| Facility | | $226.72 | $3,839.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $107.96 / $113.36 / $113.36
| Facility | 52 | $107.96 | $113.36 | $113.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,910.04 / $5,306.09 / $15,482.32
| Facility | | $2,910.04 | $5,306.09 | $15,482.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $4,761.00 / $8,451.00
| Facility | | $657.00 | $4,761.00 | $8,451.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $113.36 / $113.36 / $113.36
| Facility | 52 | $113.36 | $113.36 | $113.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.72 / $206.69 / $206.69
| Facility | | $204.72 | $206.69 | $206.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.00 / $2,391.00 / $6,322.00
| Facility | | $625.00 | $2,391.00 | $6,322.00 |