- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.46 / $214.46 / $3,638.00
| Facility | | $214.46 | $214.46 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $107.23 / $107.23 / $107.23
| Facility | 52 | $107.23 | $107.23 | $107.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,484.36 / $3,158.65 / $6,762.24
| Facility | | $1,484.36 | $3,158.65 | $6,762.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $502.04 / $783.55 / $1,884.93
| Facility | | $502.04 | $783.55 | $1,884.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.06 / $715.04 / $1,484.20
| Facility | | $435.06 | $715.04 | $1,484.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $242.16 / $457.99 / $2,046.80
| Facility | | $242.16 | $457.99 | $2,046.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |