- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,394.00 / $8,400.00
| Facility | | $1,000.00 | $3,394.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $121.27 / $163.65 / $1,804.00
| Facility | 52 | $121.27 | $163.65 | $1,804.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $728.07 / $728.07 / $728.07
| Facility | | $728.07 | $728.07 | $728.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $1,098.00 / $2,437.00
| Facility | | $800.00 | $1,098.00 | $2,437.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.11 / $315.30 / $3,019.00
| Facility | | $202.11 | $315.30 | $3,019.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |