- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,281.50 / $8,101.00 / $16,345.36
| Facility | | $2,281.50 | $8,101.00 | $16,345.36 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $307.02 / $307.02 / $564.29
| Facility | 52 | $307.02 | $307.02 | $564.29 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $122.81 / $122.81 / $225.72
| Facility | 53 | $122.81 | $122.81 | $225.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,494.00 / $2,089.51 / $4,400.51
| Facility | | $1,494.00 | $2,089.51 | $4,400.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,573.00 / $10,972.00 / $34,239.00
| Facility | | $7,573.00 | $10,972.00 | $34,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.71 / $1,506.86 / $10,454.00
| Facility | | $511.71 | $1,506.86 | $10,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,407.00 / $15,108.00
| Facility | | $2,269.00 | $6,407.00 | $15,108.00 |