- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $120.09 / $120.09 / $120.09
| Facility | 52 | $120.09 | $120.09 | $120.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,100.60 / $4,495.00 / $7,888.43
| Facility | | $3,100.60 | $4,495.00 | $7,888.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.17 / $420.30 / $765.87
| Facility | | $240.17 | $420.30 | $765.87 |
- 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
- $481.88 / $619.98 / $1,555.47
| Facility | | $481.88 | $619.98 | $1,555.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |