- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $4,570.88 / $11,220.18
| Facility | | $977.24 | $4,570.88 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,000.00 / $19,054.61
| Facility | | $3,548.13 | $10,000.00 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,862.09 / $5,248.07
| Facility | | $851.14 | $1,862.09 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,023.29
| Facility | 52 | $1,023.29 | $1,023.29 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |