- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $7,655.00 / $13,151.00
| Facility | | $1,700.00 | $7,655.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $150.63 / $150.63 / $197.01
| Facility | 52 | $150.63 | $150.63 | $197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $914.00
| Facility | | $914.00 | $914.00 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $228.81 / $335.38 / $1,124.00
| Facility | | $228.81 | $335.38 | $1,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.00 / $1,743.00 / $5,562.00
| Facility | | $783.00 | $1,743.00 | $5,562.00 |