- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,684.00 / $18,600.00
| Facility | | $1,000.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $423.95 / $423.95 / $423.95
| Facility | 52 | $423.95 | $423.95 | $423.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $769.68 / $1,083.54 / $6,155.68
| Facility | | $769.68 | $1,083.54 | $6,155.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,767.26 / $2,767.26 / $2,767.26
| Facility | 52 | $2,767.26 | $2,767.26 | $2,767.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.00 / $1,760.00 / $6,155.68
| Facility | | $350.00 | $1,760.00 | $6,155.68 |