- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $19,276.96
| Facility | | $4,083.97 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $98.91 / $98.91 / $98.91
| Facility | 52 | $98.91 | $98.91 | $98.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,430.26 / $12,221.51 / $21,447.95
| Facility | | $8,430.26 | $12,221.51 | $21,447.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $197.82 / $346.19 / $586.37
| Facility | | $197.82 | $346.19 | $586.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $18,115.80 / $18,115.80 / $18,115.80
| Facility | 52 | $18,115.80 | $18,115.80 | $18,115.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.56 / $511.25 / $7,581.60
| Facility | | $397.56 | $511.25 | $7,581.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |