- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $3,821.00 / $12,600.00
| Facility | | $1,048.00 | $3,821.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $117.01 / $117.01 / $117.01
| Facility | 52 | $117.01 | $117.01 | $117.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,925.36 / $4,614.14 / $7,317.23
| Facility | | $2,925.36 | $4,614.14 | $7,317.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $216.73 / $334.73 / $5,975.00
| Facility | | $216.73 | $334.73 | $5,975.00 |
- 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
- $1,157.00 / $3,700.00 / $7,077.94
| Facility | | $1,157.00 | $3,700.00 | $7,077.94 |