- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.52 / $729.52 / $1,400.00
| Facility | | $729.52 | $729.52 | $1,400.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $364.76 / $364.76 / $364.76
| Facility | 52 | $364.76 | $364.76 | $364.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.80 / $912.17 / $993.82
| Facility | | $803.80 | $912.17 | $993.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.17 / $860.17 / $860.17
| Facility | | $860.17 | $860.17 | $860.17 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $677.34 / $677.34 / $677.34
| Facility | 52 | $677.34 | $677.34 | $677.34 |