- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $892.00 / $2,623.77 / $9,618.68
| Facility | | $892.00 | $2,623.77 | $9,618.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $676.23 / $676.23 / $1,852.87
| Facility | 52 | $676.23 | $676.23 | $1,852.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,957.42 / $4,957.42 / $4,957.42
| Facility | | $4,957.42 | $4,957.42 | $4,957.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.00 / $8,363.00 / $15,000.00
| Facility | | $1,360.00 | $8,363.00 | $15,000.00 |