- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.10 / $4,723.00 / $11,627.00
| Facility | | $759.10 | $4,723.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $379.55 / $564.39 / $1,247.81
| Facility | 52 | $379.55 | $564.39 | $1,247.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,142.00 / $12,455.21 / $21,287.94
| Facility | | $4,142.00 | $12,455.21 | $21,287.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.16 / $864.19 / $1,350.30
| Facility | | $720.16 | $864.19 | $1,350.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |