- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.84 / $3,141.00 / $13,727.26
| Facility | | $663.84 | $3,141.00 | $13,727.26 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $331.92 / $331.92 / $331.92
| Facility | 52 | $331.92 | $331.92 | $331.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,123.08 / $16,192.78 / $36,581.76
| Facility | | $3,123.08 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,586.83 / $2,250.32 / $5,413.44
| Facility | | $1,586.83 | $2,250.32 | $5,413.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,289.97 / $2,057.33 / $4,262.55
| Facility | | $1,289.97 | $2,057.33 | $4,262.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.34 / $2,114.04 / $17,937.24
| Facility | | $991.34 | $2,114.04 | $17,937.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |