- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,763.29
| Facility | | $1,000.00 | $7,838.38 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $139.97 / $139.97 / $139.97
| Facility | 52 | $139.97 | $139.97 | $139.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,034.41 / $5,013.45 / $8,176.28
| Facility | | $2,034.41 | $5,013.45 | $8,176.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $294.83 / $294.83 / $1,023.75
| Facility | | $294.83 | $294.83 | $1,023.75 |
- 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
- $243.50 / $283.79 / $459.38
| Facility | | $243.50 | $283.79 | $459.38 |
- 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
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |