- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,432.00 / $5,297.00 / $8,031.00
| Facility | | $2,432.00 | $5,297.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $174.64 / $174.64 / $217.85
| Facility | 52 | $174.64 | $174.64 | $217.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,613.00 / $4,356.81 / $8,217.00
| Facility | | $2,613.00 | $4,356.81 | $8,217.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $1,924.63 / $2,687.00
| Facility | | $1,020.00 | $1,924.63 | $2,687.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.56 / $886.65 / $1,552.85
| Facility | | $735.56 | $886.65 | $1,552.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $911.00 / $4,879.00 / $7,560.00
| Facility | | $911.00 | $4,879.00 | $7,560.00 |