- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.00 / $2,933.00 / $7,562.14
| Facility | | $1,389.00 | $2,933.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,188.66 / $1,571.83 / $2,575.42
| Facility | | $1,188.66 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.09 / $126.36 / $2,017.00
| Facility | | $101.09 | $126.36 | $2,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $214.05 / $6,012.68 / $6,012.68
| Facility | 52 | $214.05 | $6,012.68 | $6,012.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.00 / $2,517.00 / $4,486.00
| Facility | | $966.00 | $2,517.00 | $4,486.00 |