- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,710.05 / $4,931.50 / $13,363.50
| Facility | | $1,710.05 | $4,931.50 | $13,363.50 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $734.15 / $763.87 / $1,120.91
| Facility | 52 | $734.15 | $763.87 | $1,120.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,745.00 / $20,581.00 / $47,597.80
| Facility | | $11,745.00 | $20,581.00 | $47,597.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.29 / $1,659.29 / $1,776.11
| Facility | | $1,659.29 | $1,659.29 | $1,776.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,312.03 / $1,312.03 / $1,312.03
| Facility | 52 | $1,312.03 | $1,312.03 | $1,312.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $164.00 / $164.00 / $164.00
| Facility | AS | $164.00 | $164.00 | $164.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,505.00 / $10,927.00 / $24,484.00
| Facility | | $4,505.00 | $10,927.00 | $24,484.00 |