- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.05 / $2,500.00 / $7,105.44
| Facility | | $1,062.05 | $2,500.00 | $7,105.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $445.30 / $498.87 / $592.65
| Facility | 52 | $445.30 | $498.87 | $592.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,242.09 / $9,242.09 / $11,090.51
| Facility | | $9,242.09 | $9,242.09 | $11,090.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.88 / $947.88 / $947.88
| Facility | | $947.88 | $947.88 | $947.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,362.20 / $7,362.20 / $7,362.20
| Facility | | $7,362.20 | $7,362.20 | $7,362.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $4,555.00 / $8,929.00
| Facility | | $2,000.00 | $4,555.00 | $8,929.00 |