- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,429.18 / $9,842.25
| Facility | | $1,000.00 | $4,429.18 | $9,842.25 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $136.07 / $136.07 / $136.07
| Facility | 52 | $136.07 | $136.07 | $136.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,175.22 / $6,530.30 / $10,188.56
| Facility | | $4,175.22 | $6,530.30 | $10,188.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $261.39 / $357.93 / $5,543.93
| Facility | | $261.39 | $357.93 | $5,543.93 |
- 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
- $884.00 / $2,900.00 / $5,543.93
| Facility | | $884.00 | $2,900.00 | $5,543.93 |