- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.04 / $1,123.00 / $11,093.00
| Facility | | $256.04 | $1,123.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $128.02 / $128.02 / $198.96
| Facility | 52 | $128.02 | $128.02 | $198.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $5,757.57 / $8,240.00
| Facility | | $800.00 | $5,757.57 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.45 / $306.08 / $353.18
| Facility | | $235.45 | $306.08 | $353.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.83 / $761.00 / $1,158.10
| Facility | | $294.83 | $761.00 | $1,158.10 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $230.55 / $230.55 / $230.55
| Facility | 52 | $230.55 | $230.55 | $230.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,817.00 / $5,402.00
| Facility | | $900.00 | $3,817.00 | $5,402.00 |