- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,145.78 / $7,838.38
| Facility | | $1,000.00 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $425.48 / $425.48 / $425.48
| Facility | 52 | $425.48 | $425.48 | $425.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,614.22 / $55,468.25 / $88,934.84
| Facility | | $16,614.22 | $55,468.25 | $88,934.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.79 / $1,053.56 / $1,255.03
| Facility | | $827.79 | $1,053.56 | $1,255.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,834.00 / $25,932.00 / $25,932.00
| Facility | | $11,834.00 | $25,932.00 | $25,932.00 |