- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.11 / $3,500.00 / $9,367.00
| Facility | | $891.11 | $3,500.00 | $9,367.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $351.00 / $351.00 / $445.56
| Facility | 52 | $351.00 | $351.00 | $445.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,995.82 / $14,597.59 / $20,470.20
| Facility | | $7,995.82 | $14,597.59 | $20,470.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,049.36 / $8,049.36 / $8,049.36
| Facility | | $8,049.36 | $8,049.36 | $8,049.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,284.00 / $5,780.00 / $12,353.00
| Facility | | $1,284.00 | $5,780.00 | $12,353.00 |