- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $4,265.80 / $10,964.78
| Facility | | $588.84 | $4,265.80 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | 52 | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $5,011.87 / $13,803.84
| Facility | | $1,737.80 | $5,011.87 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.23 / $660.69 / $7,079.46
| Facility | | $316.23 | $660.69 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $436.52 / $436.52 / $436.52
| Facility | 22 | $436.52 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $295.12 / $295.12 / $295.12
| Facility | 52 | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $5,128.61 / $12,882.50
| Facility | | $1,348.96 | $5,128.61 | $12,882.50 |