- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,839.93 / $7,629.00 / $10,613.33
| Facility | | $2,839.93 | $7,629.00 | $10,613.33 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $3,551.12 / $9,918.70 / $37,036.93
| Facility | 50 | $3,551.12 | $9,918.70 | $37,036.93 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,025.28 / $1,025.28 / $1,359.74
| Facility | 52 | $1,025.28 | $1,025.28 | $1,359.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,802.79 / $16,133.17 / $21,953.20
| Facility | | $6,802.79 | $16,133.17 | $21,953.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,565.00 / $7,010.00 / $11,152.00
| Facility | | $4,565.00 | $7,010.00 | $11,152.00 |