- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.01 / $2,588.69 / $5,017.20
| Facility | | $460.01 | $2,588.69 | $5,017.20 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $230.00 / $457.89 / $457.89
| Facility | 52 | $230.00 | $457.89 | $457.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,449.90 / $1,611.00 / $2,875.00
| Facility | | $1,449.90 | $1,611.00 | $2,875.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,472.40 / $2,472.40 / $2,558.92
| Facility | | $2,472.40 | $2,472.40 | $2,558.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.00 / $4,314.00 / $9,565.00
| Facility | | $691.00 | $4,314.00 | $9,565.00 |