- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $8,146.00 / $19,554.00
| Facility | | $1,000.00 | $8,146.00 | $19,554.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $329.83 / $365.86 / $370.92
| Facility | 52 | $329.83 | $365.86 | $370.92 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $131.93 / $146.34 / $148.37
| Facility | 53 | $131.93 | $146.34 | $148.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $400.00 / $10,000.00
| Facility | | $323.00 | $400.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,460.00 / $21,065.00 / $32,051.00
| Facility | | $9,460.00 | $21,065.00 | $32,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,320.00 / $10,309.00 / $15,888.00
| Facility | | $3,320.00 | $10,309.00 | $15,888.00 |