- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $7,585.78 / $17,782.79
| Facility | | $2,951.21 | $7,585.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | 52 | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $3,981.07 / $10,471.29
| Facility | | $66.07 | $3,981.07 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,659.59 / $2,630.27
| Facility | | $660.69 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.17 / $275.42 / $371.54
| Professional | | $204.17 | $275.42 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $275.42 / $562.34
| Professional | | $218.78 | $275.42 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $7,943.28 / $33,884.42
| Facility | | $7,943.28 | $7,943.28 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | 52 | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $338.84 / $575.44
| Facility | | $245.47 | $338.84 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $4,265.80 / $4,265.80
| Facility | | $4,265.80 | $4,265.80 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,079.46 / $14,454.40
| Facility | | $3,090.30 | $7,079.46 | $14,454.40 |