- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,754.40 / $10,471.29
| Facility | | $1,023.29 | $5,754.40 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $4,168.69
| Facility | 52 | $2,691.53 | $2,691.53 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $1,995.26 / $3,890.45
| Facility | | $436.52 | $1,995.26 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $346.74 / $346.74 / $346.74
| Facility | 52 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,244.36 / $13,803.84
| Facility | | $2,511.89 | $7,244.36 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $5,370.32 / $10,000.00
| Facility | | $812.83 | $5,370.32 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,691.53 / $2,691.53 / $4,168.69
| Facility | 52 | $2,691.53 | $2,691.53 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $5,370.32 / $6,760.83
| Facility | | $323.59 | $5,370.32 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $338.84 / $588.84
| Facility | | $251.19 | $338.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,951.21 / $9,549.93
| Facility | | $851.14 | $2,951.21 | $9,549.93 |