- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33.88 / $3,715.35 / $10,715.19
| Facility | | $33.88 | $3,715.35 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,801.89 / $9,549.93
| Facility | | $1,584.89 | $3,801.89 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32.36 / $83.18 / $794.33
| Facility | | $32.36 | $83.18 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $26.30 / $26.30 / $26.30
| Facility | 52 | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,511.89 / $6,025.60
| Facility | | $660.69 | $2,511.89 | $6,025.60 |