- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $5,194.00 / $10,302.36
| Facility | | $902.00 | $5,194.00 | $10,302.36 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $14.12 / $14.12 / $18.27
| Facility | 52 | $14.12 | $14.12 | $18.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $4,613.09 / $8,848.00
| Facility | | $2,807.00 | $4,613.09 | $8,848.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.00 / $1,121.14 / $1,290.78
| Facility | | $767.00 | $1,121.14 | $1,290.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.58 / $809.30 / $1,135.28
| Facility | | $626.58 | $809.30 | $1,135.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $911.00 / $5,307.00 / $8,879.00
| Facility | | $911.00 | $5,307.00 | $8,879.00 |