- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,553.00 / $6,071.00 / $13,151.00
| Facility | | $2,553.00 | $6,071.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $673.24 / $673.24 / $881.71
| Facility | 52 | $673.24 | $673.24 | $881.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,594.00 / $6,528.39 / $9,893.29
| Facility | | $3,594.00 | $6,528.39 | $9,893.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $914.00
| Facility | | $914.00 | $914.00 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.71 / $1,451.65 / $5,413.00
| Facility | | $1,038.71 | $1,451.65 | $5,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.00 / $4,650.00 / $11,732.00
| Facility | | $1,202.00 | $4,650.00 | $11,732.00 |