- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,266.86 / $6,024.00 / $16,144.00
| Facility | | $1,266.86 | $6,024.00 | $16,144.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,100.00 / $10,123.36 / $10,937.43
| Facility | 50 | $2,100.00 | $10,123.36 | $10,937.43 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $594.72 / $633.44 / $656.48
| Facility | 52 | $594.72 | $633.44 | $656.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $400.00 / $10,000.00
| Facility | | $323.00 | $400.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,460.00 / $21,162.00 / $32,051.00
| Facility | | $9,460.00 | $21,162.00 | $32,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,681.00 / $5,811.00 / $10,057.00
| Facility | | $1,681.00 | $5,811.00 | $10,057.00 |