- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,181.00 / $1,782.00 / $9,034.00
| Facility | | $1,181.00 | $1,782.00 | $9,034.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $616.79 / $635.91 / $935.77
| Facility | 52 | $616.79 | $635.91 | $935.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,518.88 / $2,518.88 / $2,871.52
| Facility | | $2,518.88 | $2,518.88 | $2,871.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.00 / $541.00 / $561.00
| Facility | | $515.00 | $541.00 | $561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,565.00 / $2,667.00 / $6,957.00
| Facility | | $1,565.00 | $2,667.00 | $6,957.00 |