- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.19 / $1,831.00 / $5,025.00
| Facility | | $608.19 | $1,831.00 | $5,025.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $276.98 / $276.98 / $678.45
| Facility | 52 | $276.98 | $276.98 | $678.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,665.14 / $4,665.14 / $4,665.14
| Facility | | $4,665.14 | $4,665.14 | $4,665.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,065.01 / $5,065.01 / $9,527.83
| Facility | | $5,065.01 | $5,065.01 | $9,527.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $4,797.00 / $10,455.00
| Facility | | $1,185.00 | $4,797.00 | $10,455.00 |