- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.32 / $2,747.00 / $6,563.22
| Facility | | $450.32 | $2,747.00 | $6,563.22 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $126.39 / $126.39 / $126.39
| Facility | 52 | $126.39 | $126.39 | $126.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.67 / $2,628.00 / $26,542.00
| Facility | | $636.67 | $2,628.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $534.11 / $5,997.52 / $5,997.52
| Facility | 52 | $534.11 | $5,997.52 | $5,997.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.00 / $920.70 / $3,103.98
| Facility | | $837.00 | $920.70 | $3,103.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $264.36 / $714.00 / $6,679.00
| Facility | | $264.36 | $714.00 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,231.20 / $5,666.53 / $8,433.50
| Facility | | $4,231.20 | $5,666.53 | $8,433.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $4,249.00 / $26,542.00
| Facility | | $1,061.00 | $4,249.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $534.11 / $5,997.52 / $5,997.52
| Facility | 52 | $534.11 | $5,997.52 | $5,997.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |