- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,440.07 / $8,399.00 / $15,674.72
| Facility | | $2,440.07 | $8,399.00 | $15,674.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $612.21 / $910.36 / $2,389.21
| Facility | 52 | $612.21 | $910.36 | $2,389.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $8,010.00 / $36,529.00
| Facility | | $2,097.00 | $8,010.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,129.24 / $1,411.55 / $1,677.22
| Facility | | $1,129.24 | $1,411.55 | $1,677.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,247.74 / $12,670.46 / $16,563.40
| Facility | | $9,247.74 | $12,670.46 | $16,563.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,873.00 / $10,707.00 / $15,469.00
| Facility | | $4,873.00 | $10,707.00 | $15,469.00 |