- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $574.84 / $574.84 / $574.84
| Facility | 52 | $574.84 | $574.84 | $574.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,149.67 / $1,384.23 / $1,768.76
| Professional | | $1,149.67 | $1,384.23 | $1,768.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,335.87 / $4,387.57 / $8,486.99
| Facility | | $3,335.87 | $4,387.57 | $8,486.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,105.75 / $1,875.40 / $2,513.07
| Professional | | $1,105.75 | $1,875.40 | $2,513.07 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,195.09 / $2,801.64 / $3,842.19
| Professional | | $1,195.09 | $2,801.64 | $3,842.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,462.70 / $2,718.89 / $8,632.00
| Facility | | $1,462.70 | $2,718.89 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $8,418.48 / $8,418.48 / $8,418.48
| Facility | 52 | $8,418.48 | $8,418.48 | $8,418.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,052.31 / $1,052.31 / $1,052.31
| Facility | AS | $1,052.31 | $1,052.31 | $1,052.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,524.79 / $2,719.21 / $9,294.87
| Professional | | $1,524.79 | $2,719.21 | $9,294.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,620.30 / $2,971.90 / $3,929.20
| Facility | | $1,620.30 | $2,971.90 | $3,929.20 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,001.00 / $2,774.36 / $3,454.05
| Professional | | $2,001.00 | $2,774.36 | $3,454.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,524.79 / $2,601.82 / $2,939.45
| Professional | | $1,524.79 | $2,601.82 | $2,939.45 |