- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,630.27 / $6,606.93
| Facility | | $1,000.00 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.08 / $537.03 / $707.95
| Facility | | $363.08 | $537.03 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19.50 / $34.67 / $2,951.21
| Facility | | $19.50 | $34.67 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 52 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,949.84 / $3,467.37
| Facility | | $501.19 | $1,949.84 | $3,467.37 |