- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $7,413.10 / $18,197.01
| Facility | | $1,230.27 | $7,413.10 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,096.48 / $3,388.44 / $8,709.64
| Facility | 52 | $1,096.48 | $3,388.44 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $10,964.78 / $23,442.29
| Facility | | $3,981.07 | $10,964.78 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $2,754.23 / $15,848.93
| Facility | | $1,122.02 | $2,754.23 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $1,348.96 / $1,348.96 / $1,348.96
| Facility | 22 | $1,348.96 | $1,348.96 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $912.01 / $912.01 / $912.01
| Facility | 52 | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.20 / $112.20 / $112.20
| Facility | AS | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.95 / $8,912.51 / $20,417.38
| Facility | | $3,019.95 | $8,912.51 | $20,417.38 |