- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.00 / $1,300.00 / $3,500.00
| Facility | | $483.00 | $1,300.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $531.86 / $564.84 / $634.35
| Facility | 52 | $531.86 | $564.84 | $634.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,163.79 / $22,915.43 / $40,816.46
| Facility | | $13,163.79 | $22,915.43 | $40,816.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $40.00
| Facility | | $40.00 | $40.00 | $40.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $11,159.00 / $24,651.00
| Facility | | $1,200.00 | $11,159.00 | $24,651.00 |