- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $5,623.41 / $29,512.09
| Facility | | $575.44 | $5,623.41 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $8,317.64 / $16,218.10
| Facility | | $2,238.72 | $8,317.64 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $33,884.42 / $57,543.99
| Facility | | $22,908.68 | $33,884.42 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $4,466.84 / $31,622.78
| Facility | | $524.81 | $4,466.84 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $891.25 / $41,686.94 / $41,686.94
| Facility | 52 | $891.25 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $223.87 / $10,232.93 / $10,232.93
| Facility | 53 | $223.87 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $4,466.84 / $22,387.21
| Facility | | $3,388.44 | $4,466.84 | $22,387.21 |