- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.13 / $2,010.00 / $6,927.01
| Facility | | $678.13 | $2,010.00 | $6,927.01 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $116.92 / $116.92 / $357.83
| Facility | 52 | $116.92 | $116.92 | $357.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.16 / $1,440.16 / $1,584.18
| Facility | | $1,440.16 | $1,440.16 | $1,584.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $726.00 / $1,262.11 / $3,384.29
| Facility | | $726.00 | $1,262.11 | $3,384.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $2,011.00 / $6,612.00
| Facility | | $700.00 | $2,011.00 | $6,612.00 |