- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $18,620.87 / $33,113.11
| Facility | | $467.74 | $18,620.87 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1.00 / $16,595.87 / $26,302.68
| Facility | | $1.00 | $16,595.87 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,548.82 / $3,715.35
| Facility | | $1,096.48 | $1,548.82 | $3,715.35 |
- 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
- $1,202.26 / $1,479.11 / $2,884.03
| Facility | | $1,202.26 | $1,479.11 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $7,762.47 / $18,620.87
| Facility | | $645.65 | $7,762.47 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $14,125.38 / $40,738.03
| Facility | | $8,317.64 | $14,125.38 | $40,738.03 |