- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.77 / $1,342.00 / $3,804.00
| Facility | | $517.77 | $1,342.00 | $3,804.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $179.57 / $179.57 / $292.48
| Facility | 52 | $179.57 | $179.57 | $292.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,329.99 / $5,329.99 / $6,076.19
| Facility | | $5,329.99 | $5,329.99 | $6,076.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $561.00 / $4,522.97
| Facility | | $515.00 | $561.00 | $4,522.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $1,106.00 / $2,539.00
| Facility | | $505.00 | $1,106.00 | $2,539.00 |