- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $6,456.54 / $10,471.29
| Facility | | $4,265.80 | $6,456.54 | $10,471.29 |
- 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
- $363.08 / $2,754.23 / $3,630.78
| Facility | | $363.08 | $2,754.23 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,054.61 / $30,199.52
| Facility | | $12,302.69 | $19,054.61 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $7,413.10 / $15,135.61
| Facility | | $3,162.28 | $7,413.10 | $15,135.61 |