- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,612.00 / $8,400.00
| Facility | | $1,000.00 | $3,612.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $76.34 / $76.34 / $76.34
| Facility | 52 | $76.34 | $76.34 | $76.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,925.36 / $4,614.14 / $7,317.23
| Facility | | $2,925.36 | $4,614.14 | $7,317.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.43 / $219.63 / $4,000.00
| Facility | | $146.43 | $219.63 | $4,000.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,716.72 / $3,716.72 / $3,716.72
| Facility | 52 | $3,716.72 | $3,716.72 | $3,716.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.00 / $1,928.00 / $4,012.00
| Facility | | $575.00 | $1,928.00 | $4,012.00 |