- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.94 / $1,277.00 / $3,804.00
| Facility | | $190.94 | $1,277.00 | $3,804.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $87.82 / $95.47 / $126.55
| Facility | 52 | $87.82 | $95.47 | $126.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,771.26 / $1,771.26 / $2,019.24
| Facility | | $1,771.26 | $1,771.26 | $2,019.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $515.00 / $930.22
| Facility | | $490.00 | $515.00 | $930.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $1,106.00 / $2,539.00
| Facility | | $505.00 | $1,106.00 | $2,539.00 |