- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $2,589.84 / $20,296.00
| Facility | | $100.00 | $2,589.84 | $20,296.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $633.73 / $1,294.92 / $1,294.92
| Facility | 52 | $633.73 | $1,294.92 | $1,294.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,512.20 / $9,458.00 / $17,300.00
| Facility | | $8,512.20 | $9,458.00 | $17,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.46 / $5,257.46 / $5,441.47
| Facility | | $5,257.46 | $5,257.46 | $5,441.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,111.00 / $4,660.00 / $12,399.00
| Facility | | $1,111.00 | $4,660.00 | $12,399.00 |