- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,175.00 / $3,843.00 / $10,439.00
| Facility | | $1,175.00 | $3,843.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $87.86 / $87.86 / $118.41
| Facility | 52 | $87.86 | $87.86 | $118.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.00 / $911.76 / $1,543.97
| Facility | | $653.00 | $911.76 | $1,543.97 |
- 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
- $146.43 / $213.93 / $3,181.00
| Facility | | $146.43 | $213.93 | $3,181.00 |
- 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 |