- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,714.00 / $7,040.00 / $13,151.00
| Facility | | $1,714.00 | $7,040.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $842.02 / $842.02 / $1,104.50
| Facility | 52 | $842.02 | $842.02 | $1,104.50 |
- 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
- $1,087.00 / $1,653.59 / $2,951.38
| Facility | | $1,087.00 | $1,653.59 | $2,951.38 |
- 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 |