- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $6,606.93
| Facility | | $912.01 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $5,495.41 / $8,709.64
| Facility | | $3,467.37 | $5,495.41 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $158.49 / $4,168.69
| Facility | | $104.71 | $158.49 | $4,168.69 |
- 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
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,089.30 / $4,073.80
| Facility | | $575.44 | $2,089.30 | $4,073.80 |