- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $314.69 / $1,964.45 / $8,423.37
| Facility | | $314.69 | $1,964.45 | $8,423.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $148.62 / $157.34 / $261.77
| Facility | 52 | $148.62 | $157.34 | $261.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,893.49 / $2,893.49 / $3,298.58
| Facility | | $2,893.49 | $2,893.49 | $3,298.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $693.00 / $2,519.08
| Facility | | $515.00 | $693.00 | $2,519.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $1,461.00 / $3,384.00
| Facility | | $750.00 | $1,461.00 | $3,384.00 |