- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $5,370.32 / $10,964.78
| Facility | | $660.69 | $5,370.32 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3.80 / $4,168.69 / $4,786.30
| Facility | 52 | $3.80 | $4,168.69 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $7,585.78 / $14,791.08
| Facility | | $2,630.27 | $7,585.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $870.96 / $2,344.23
| Facility | | $436.52 | $870.96 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 52 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $3,981.07 / $9,549.93
| Facility | | $1,023.29 | $3,981.07 | $9,549.93 |