- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,095.00 / $7,838.38 / $8,882.33
| Facility | | $2,095.00 | $7,838.38 | $8,882.33 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $349.27 / $349.27 / $349.27
| Facility | 52 | $349.27 | $349.27 | $349.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,376.73 / $24,627.95 / $39,487.14
| Facility | | $7,376.73 | $24,627.95 | $39,487.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $844.51 / $1,074.82 / $1,231.78
| Facility | | $844.51 | $1,074.82 | $1,231.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,028.00 / $15,131.00 / $16,269.00
| Facility | | $9,028.00 | $15,131.00 | $16,269.00 |