- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $7,598.64 / $19,148.84
| Facility | | $5,005.00 | $7,598.64 | $19,148.84 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $118.90 / $118.90 / $2,502.50
| Facility | 52 | $118.90 | $118.90 | $2,502.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,074.79 / $8,806.74 / $15,455.25
| Facility | | $6,074.79 | $8,806.74 | $15,455.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.80 / $404.61 / $4,037.06
| Facility | | $237.80 | $404.61 | $4,037.06 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5,997.52 / $5,997.52 / $5,997.52
| Facility | 52 | $5,997.52 | $5,997.52 | $5,997.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.19 / $638.19 / $2,440.29
| Facility | | $462.19 | $638.19 | $2,440.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |