- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,763.29
| Facility | | $1,000.00 | $7,838.38 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $421.79 / $421.79 / $421.79
| Facility | 52 | $421.79 | $421.79 | $421.79 |
- 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
- $924.74 / $1,176.95 / $1,425.55
| Facility | | $924.74 | $1,176.95 | $1,425.55 |
- 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 |