- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,570.88 / $12,302.69
| Facility | | $1,000.00 | $4,570.88 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $9,120.11 / $16,982.44
| Facility | | $3,388.44 | $9,120.11 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $1,445.44 / $5,888.44
| Facility | | $323.59 | $1,445.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $1,148.15
| Facility | 52 | $1,148.15 | $1,148.15 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,818.38 / $9,772.37
| Facility | | $537.03 | $2,818.38 | $9,772.37 |