- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.71 / $5,042.41 / $10,941.00
| Facility | | $670.71 | $5,042.41 | $10,941.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $152.16 / $335.36 / $335.36
| Facility | 52 | $152.16 | $335.36 | $335.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,344.14 / $3,858.58 / $8,996.26
| Facility | | $1,344.14 | $3,858.58 | $8,996.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $810.00 / $1,838.22
| Facility | | $375.00 | $810.00 | $1,838.22 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $232.05 / $232.05 / $232.05
| Facility | 52 | $232.05 | $232.05 | $232.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $266.81 / $346.70 / $582.00
| Facility | | $266.81 | $346.70 | $582.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.00 / $10,069.00 / $16,249.00
| Facility | | $710.00 | $10,069.00 | $16,249.00 |