- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.65 / $9,622.00 / $40,073.00
| Facility | | $527.65 | $9,622.00 | $40,073.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $263.83 / $263.83 / $263.83
| Facility | 52 | $263.83 | $263.83 | $263.83 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $105.53 / $105.53 / $105.53
| Facility | 53 | $105.53 | $105.53 | $105.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,795.73 / $12,838.03 / $20,681.46
| Facility | | $5,795.73 | $12,838.03 | $20,681.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,616.34 / $29,127.00 / $58,466.00
| Facility | | $4,616.34 | $29,127.00 | $58,466.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $483.75 / $596.16 / $1,181.23
| Facility | | $483.75 | $596.16 | $1,181.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $20,813.00 / $27,446.00
| Facility | | $3,028.00 | $20,813.00 | $27,446.00 |