- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,241.00 / $6,071.00 / $14,977.50
| Facility | | $1,241.00 | $6,071.00 | $14,977.50 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $348.32 / $348.32 / $380.45
| Facility | 52 | $348.32 | $348.32 | $380.45 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $139.33 / $139.33 / $152.18
| Facility | 53 | $139.33 | $139.33 | $152.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,156.00 / $1,542.88 / $2,568.26
| Facility | | $1,156.00 | $1,542.88 | $2,568.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,968.00 / $27,391.00 / $34,239.00
| Facility | | $22,968.00 | $27,391.00 | $34,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.53 / $1,108.46 / $16,026.00
| Facility | | $580.53 | $1,108.46 | $16,026.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,081.00 / $7,665.00 / $19,827.00
| Facility | | $3,081.00 | $7,665.00 | $19,827.00 |