- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,467.00 / $12,237.00
| Facility | | $1,500.00 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $483.38 / $483.38 / $634.73
| Facility | 52 | $483.38 | $483.38 | $634.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,027.71 / $1,199.00 / $8,874.57
| Facility | | $1,027.71 | $1,199.00 | $8,874.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.00 / $831.00 / $914.00
| Facility | | $831.00 | $831.00 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.81 / $1,082.19 / $2,872.00
| Facility | | $801.81 | $1,082.19 | $2,872.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,405.00 / $3,647.00 / $6,988.00
| Facility | | $1,405.00 | $3,647.00 | $6,988.00 |