- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.00 / $4,856.00 / $14,100.00
| Facility | | $1,474.00 | $4,856.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $847.45 / $847.45 / $847.45
| Facility | 52 | $847.45 | $847.45 | $847.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,426.66 / $29,273.44 / $46,251.71
| Facility | | $18,426.66 | $29,273.44 | $46,251.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,601.73 / $2,325.51 / $10,836.00
| Facility | | $1,601.73 | $2,325.51 | $10,836.00 |
- 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
- $1,481.00 / $6,026.00 / $10,811.00
| Facility | | $1,481.00 | $6,026.00 | $10,811.00 |