- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $5,495.41 / $27,542.29
| Facility | | $812.83 | $5,495.41 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | 53 | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $9,549.93 / $19,952.62
| Facility | | $3,548.13 | $9,549.93 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $12,589.25 / $36,307.81
| Facility | | $776.25 | $12,589.25 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $616.60 / $616.60 / $616.60
| Facility | 52 | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | 53 | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $14,454.40 / $38,018.94
| Facility | | $3,981.07 | $14,454.40 | $38,018.94 |