- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.00 / $4,470.00 / $10,439.00
| Facility | | $1,848.00 | $4,470.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $179.87 / $179.87 / $242.18
| Facility | 52 | $179.87 | $179.87 | $242.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,074.00 / $1,454.40 / $3,216.15
| Facility | | $1,074.00 | $1,454.40 | $3,216.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,129.00 / $2,437.00 / $5,214.00
| Facility | | $1,129.00 | $2,437.00 | $5,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.43 / $453.72 / $1,450.00
| Facility | | $268.43 | $453.72 | $1,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $2,081.00 / $3,918.00
| Facility | | $816.00 | $2,081.00 | $3,918.00 |