- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $9,696.14 / $23,483.17
| Facility | | $4,241.22 | $9,696.14 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $634.19 / $634.19 / $634.19
| Facility | 52 | $634.19 | $634.19 | $634.19 |
- 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
- $1,268.36 / $2,283.07 / $10,174.00
| Facility | | $1,268.36 | $2,283.07 | $10,174.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,844.84 / $5,159.08 / $5,159.08
| Facility | 52 | $2,844.84 | $5,159.08 | $5,159.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $355.61 / $644.89 / $644.89
| Facility | AS | $355.61 | $644.89 | $644.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,635.29 / $3,140.80 / $4,334.00
| Facility | | $1,635.29 | $3,140.80 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |