- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $604.13 / $4,414.46 / $13,675.25
| Facility | | $604.13 | $4,414.46 | $13,675.25 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $127.66 / $302.06 / $302.06
| Facility | 52 | $127.66 | $302.06 | $302.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,052.27 / $5,047.99 / $10,416.10
| Facility | | $1,052.27 | $5,047.99 | $10,416.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $5,552.43
| Facility | | $375.00 | $615.00 | $5,552.43 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $191.49 / $191.49 / $191.49
| Facility | 52 | $191.49 | $191.49 | $191.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.86 / $316.29 / $447.64
| Facility | | $225.86 | $316.29 | $447.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.00 / $12,269.00 / $19,591.00
| Facility | | $870.00 | $12,269.00 | $19,591.00 |