- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.00 / $2,007.83 / $7,702.00
| Facility | | $991.00 | $2,007.83 | $7,702.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $795.90 / $966.73 / $1,177.47
| Facility | 52 | $795.90 | $966.73 | $1,177.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.00 / $29,127.00 / $55,575.98
| Facility | | $9,271.00 | $29,127.00 | $55,575.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,696.94 / $2,460.75 / $2,838.66
| Facility | | $1,696.94 | $2,460.75 | $2,838.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.96 / $2,155.96 / $2,318.86
| Facility | | $2,155.96 | $2,155.96 | $2,318.86 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,701.26 / $1,701.26 / $1,701.26
| Facility | 52 | $1,701.26 | $1,701.26 | $1,701.26 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $212.66 / $212.66 / $212.66
| Facility | AS | $212.66 | $212.66 | $212.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,168.00 / $6,186.00 / $35,462.00
| Facility | | $1,168.00 | $6,186.00 | $35,462.00 |