- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,235.94 / $9,772.37
| Facility | | $977.24 | $3,235.94 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $5,128.61 / $28,840.32
| Facility | | $1,737.80 | $5,128.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,754.23 / $16,982.44
| Facility | | $1,318.26 | $2,754.23 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $1,096.48
| Facility | 52 | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $14,125.38 / $34,673.69
| Facility | | $4,073.80 | $14,125.38 | $34,673.69 |