- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $727.88 / $727.88 / $727.88
| Facility | 52 | $727.88 | $727.88 | $727.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.34 / $17,097.68 / $33,072.44
| Facility | | $12,999.34 | $17,097.68 | $33,072.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,455.75 / $2,620.35 / $16,016.97
| Facility | | $1,455.75 | $2,620.35 | $16,016.97 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,251.39 / $38,006.16 / $38,006.16
| Facility | 52 | $3,251.39 | $38,006.16 | $38,006.16 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $406.42 / $4,750.77 / $4,750.77
| Facility | AS | $406.42 | $4,750.77 | $4,750.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,890.98 / $3,538.55 / $4,976.41
| Facility | | $1,890.98 | $3,538.55 | $4,976.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |