- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $522.02 / $4,577.50 / $9,016.12
| Facility | | $522.02 | $4,577.50 | $9,016.12 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $132.71 / $141.96 / $216.84
| Facility | 52 | $132.71 | $141.96 | $216.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,373.00 / $4,085.00 / $8,800.00
| Facility | | $2,373.00 | $4,085.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.00 / $1,262.11 / $2,558.92
| Facility | | $606.00 | $1,262.11 | $2,558.92 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $232.05 / $232.05 / $232.05
| Facility | 52 | $232.05 | $232.05 | $232.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,099.00 / $3,399.00 / $7,254.00
| Facility | | $1,099.00 | $3,399.00 | $7,254.00 |