- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,069.16 / $6,781.00 / $21,593.40
| Facility | | $1,069.16 | $6,781.00 | $21,593.40 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $534.58 / $534.58 / $534.58
| Facility | 52 | $534.58 | $534.58 | $534.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,273.65 / $17,550.78 / $36,581.76
| Facility | | $6,273.65 | $17,550.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,852.75 / $4,045.55 / $9,732.12
| Facility | | $2,852.75 | $4,045.55 | $9,732.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,319.08 / $3,698.60 / $7,663.09
| Facility | | $2,319.08 | $3,698.60 | $7,663.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,005.02 / $7,527.00 / $23,150.96
| Facility | | $2,005.02 | $7,527.00 | $23,150.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |