- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,235.94 / $7,943.28
| Facility | | $562.34 | $3,235.94 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $407.38 / $1,318.26 / $1,819.70
| Facility | 52 | $407.38 | $1,318.26 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $4,897.79 / $10,471.29
| Facility | | $1,621.81 | $4,897.79 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $776.25 / $1,778.28
| Facility | | $331.13 | $776.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | 52 | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,630.27 / $6,165.95
| Facility | | $660.69 | $2,630.27 | $6,165.95 |