- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,716.71 / $7,655.00 / $13,151.00
| Facility | | $1,716.71 | $7,655.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $654.95 / $654.95 / $858.36
| Facility | 52 | $654.95 | $654.95 | $858.36 |
- 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
- $795.11 / $1,230.83 / $1,930.42
| Facility | | $795.11 | $1,230.83 | $1,930.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.00 / $1,743.00 / $5,562.00
| Facility | | $783.00 | $1,743.00 | $5,562.00 |