- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.00 / $3,751.00 / $8,387.50
| Facility | | $644.00 | $3,751.00 | $8,387.50 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $83.29 / $100.57 / $959.65
| Facility | 52 | $83.29 | $100.57 | $959.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $219.76 / $861.35 / $2,213.00
| Facility | | $219.76 | $861.35 | $2,213.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $172.10 / $172.10 / $172.10
| Facility | 52 | $172.10 | $172.10 | $172.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,979.00 / $5,611.00 / $11,030.00
| Facility | | $2,979.00 | $5,611.00 | $11,030.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.00 / $3,514.00 / $7,044.00
| Facility | | $573.00 | $3,514.00 | $7,044.00 |