- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,011.87 / $8,511.38
| Facility | | $2,344.23 | $5,011.87 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,370.32 / $10,471.29
| Facility | | $4,073.80 | $5,370.32 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $162.18 / $3,715.35
| Facility | | $95.50 | $162.18 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $6,025.60 / $6,025.60 / $6,025.60
| Facility | 52 | $6,025.60 | $6,025.60 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $199.53 / $245.47 / $323.59
| Professional | | $199.53 | $245.47 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,467.37 / $8,128.31
| Facility | | $2,630.27 | $3,467.37 | $8,128.31 |