- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $790.20 / $3,744.00 / $8,017.00
| Facility | | $790.20 | $3,744.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $377.99 / $377.99 / $395.10
| Facility | 52 | $377.99 | $377.99 | $395.10 |
- 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
- $49,142.16 / $64,063.27 / $90,222.53
| Facility | | $49,142.16 | $64,063.27 | $90,222.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.00 / $3,839.00 / $8,017.00
| Facility | | $954.00 | $3,839.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $377.99 / $377.99 / $377.99
| Facility | 52 | $377.99 | $377.99 | $377.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $838.10 / $838.10 / $849.59
| Facility | | $838.10 | $838.10 | $849.59 |
- 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 |