- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,001.82 / $10,458.00 / $43,806.00
| Facility | | $2,001.82 | $10,458.00 | $43,806.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $2,829.45 / $2,829.45 / $12,322.00
| Facility | 50 | $2,829.45 | $2,829.45 | $12,322.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,000.91 / $1,000.91 / $1,000.91
| Facility | 52 | $1,000.91 | $1,000.91 | $1,000.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,947.45 / $24,875.82 / $35,712.80
| Facility | | $19,947.45 | $24,875.82 | $35,712.80 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $29,921.18 / $37,313.73 / $53,569.20
| Facility | 50 | $29,921.18 | $37,313.73 | $53,569.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $10,927.00 / $47,431.00
| Facility | | $3,340.00 | $10,927.00 | $47,431.00 |