- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $326.06 / $1,632.00 / $4,478.00
| Facility | | $326.06 | $1,632.00 | $4,478.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $163.03 / $163.03 / $265.75
| Facility | 52 | $163.03 | $163.03 | $265.75 |
- 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
- $515.00 / $561.00 / $930.22
| Facility | | $515.00 | $561.00 | $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 |