- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.65 / $875.32 / $4,846.00
| Facility | | $690.65 | $875.32 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $345.33 / $345.33 / $567.40
| Facility | 52 | $345.33 | $345.33 | $567.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,091.00 / $15,580.56 / $24,062.10
| Facility | | $5,091.00 | $15,580.56 | $24,062.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $713.45 / $1,007.22 / $1,510.83
| Facility | | $713.45 | $1,007.22 | $1,510.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.00 / $5,242.00 / $10,843.00
| Facility | | $1,403.00 | $5,242.00 | $10,843.00 |