- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,468.97 / $1,468.97 / $11,352.03
| Facility | | $1,468.97 | $1,468.97 | $11,352.03 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $734.49 / $734.49 / $734.49
| Facility | 52 | $734.49 | $734.49 | $734.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.88 / $1,492.31 / $10,770.92
| Facility | | $682.88 | $1,492.31 | $10,770.92 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $989.85 / $1,501.81 / $2,633.29
| Facility | 50 | $989.85 | $1,501.81 | $2,633.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,486.13 / $4,943.77 / $11,892.90
| Facility | | $3,486.13 | $4,943.77 | $11,892.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,833.97 / $4,519.79 / $9,364.49
| Facility | | $2,833.97 | $4,519.79 | $9,364.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,371.26 / $2,735.00 / $6,740.00
| Facility | | $1,371.26 | $2,735.00 | $6,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |