- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.00 / $2,505.00 / $8,017.00
| Facility | | $832.00 | $2,505.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $357.46 / $430.78 / $430.78
| Facility | 52 | $357.46 | $430.78 | $430.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,480.74
| Facility | | $13,531.00 | $27,840.00 | $46,480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,328.43 / $43,328.43 / $43,328.43
| Facility | | $43,328.43 | $43,328.43 | $43,328.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.00 / $2,422.00 / $8,017.00
| Facility | | $657.00 | $2,422.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $430.78 / $430.78 / $430.78
| Facility | 52 | $430.78 | $430.78 | $430.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.04 / $783.04 / $852.82
| Facility | | $783.04 | $783.04 | $852.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,742.00 / $6,911.00 / $12,841.00
| Facility | | $3,742.00 | $6,911.00 | $12,841.00 |