- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $25,000.00
| Facility | | $1,671.00 | $4,474.00 | $25,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.13 / $977.17 / $2,173.00
| Facility | | $773.13 | $977.17 | $2,173.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,693.92 / $3,102.73 / $3,102.73
| Facility | 52 | $1,693.92 | $3,102.73 | $3,102.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.00 / $2,661.00 / $14,572.00
| Facility | | $1,314.00 | $2,661.00 | $14,572.00 |