- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.17 / $4,304.00 / $11,576.00
| Facility | | $709.17 | $4,304.00 | $11,576.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $337.35 / $354.59 / $374.40
| Facility | 52 | $337.35 | $354.59 | $374.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.00 / $16,921.25 / $20,144.34
| Facility | | $323.00 | $16,921.25 | $20,144.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,979.00 / $12,742.00 / $23,031.00
| Facility | | $5,979.00 | $12,742.00 | $23,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,194.00 / $18,859.00 / $45,670.00
| Facility | | $8,194.00 | $18,859.00 | $45,670.00 |