- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,739.00
| Facility | | $4,241.22 | $10,431.19 | $23,739.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $789.62 / $789.62 / $789.62
| Facility | 52 | $789.62 | $789.62 | $789.62 |
- 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
- $1,579.23 / $2,842.61 / $13,049.04
| Facility | | $1,579.23 | $2,842.61 | $13,049.04 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,534.21 / $6,418.56 / $6,418.56
| Facility | 52 | $3,534.21 | $6,418.56 | $6,418.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $441.78 / $802.32 / $802.32
| Facility | AS | $441.78 | $802.32 | $802.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,044.85 / $3,945.91 / $5,407.08
| Facility | | $2,044.85 | $3,945.91 | $5,407.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.00 / $9,696.00 / $15,622.00
| Facility | | $8,158.00 | $9,696.00 | $15,622.00 |