- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $633.22 / $8,960.00 / $46,397.27
| Facility | | $633.22 | $8,960.00 | $46,397.27 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $316.61 / $316.61 / $630.90
| Facility | 52 | $316.61 | $316.61 | $630.90 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $126.64 / $126.64 / $252.36
| Facility | 53 | $126.64 | $126.64 | $252.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,529.38 / $41,480.12 / $80,893.28
| Facility | | $13,529.38 | $41,480.12 | $80,893.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.15 / $702.20 / $1,044.42
| Facility | | $470.15 | $702.20 | $1,044.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,960.00 / $24,825.00 / $47,173.00
| Facility | | $3,960.00 | $24,825.00 | $47,173.00 |