- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,951.21 / $7,585.78
| Facility | | $1,148.15 | $2,951.21 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | 52 | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $8,128.31 / $13,489.63
| Facility | | $2,754.23 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $12,882.50 / $12,882.50
| Facility | | $54.95 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $10,232.93 / $10,232.93 / $10,232.93
| Facility | 52 | $10,232.93 | $10,232.93 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,288.25 / $1,288.25 / $1,288.25
| Facility | AS | $1,288.25 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $12,589.25 / $25,703.96
| Facility | | $6,456.54 | $12,589.25 | $25,703.96 |