- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $6,309.57 / $19,952.62
| Facility | | $1,949.84 | $6,309.57 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | 52 | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,589.25 / $34,673.69
| Facility | | $4,466.84 | $12,589.25 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $4,786.30 / $15,848.93
| Facility | | $645.65 | $4,786.30 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | 22 | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | 52 | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | AS | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $12,022.64 / $32,359.37
| Facility | | $3,630.78 | $12,022.64 | $32,359.37 |