- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.70 / $1,632.00 / $4,478.00
| Facility | | $387.70 | $1,632.00 | $4,478.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $134.78 / $134.78 / $219.82
| Facility | 52 | $134.78 | $134.78 | $219.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,329.99 / $5,329.99 / $6,076.19
| Facility | | $5,329.99 | $5,329.99 | $6,076.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $561.00 / $4,534.04
| Facility | | $515.00 | $561.00 | $4,534.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $2,268.00 / $5,626.00
| Facility | | $1,224.00 | $2,268.00 | $5,626.00 |