- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,169.82 / $6,886.79 / $14,563.72
| Facility | | $1,169.82 | $6,886.79 | $14,563.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $331.92 / $375.20 / $590.03
| Facility | 52 | $331.92 | $375.20 | $590.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $9,720.00 / $17,774.00
| Facility | | $4,989.00 | $9,720.00 | $17,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,108.17 / $6,395.51 / $7,683.64
| Facility | | $5,108.17 | $6,395.51 | $7,683.64 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $589.65 / $589.65 / $589.65
| Facility | 52 | $589.65 | $589.65 | $589.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $73.70 / $73.70 / $73.70
| Facility | AS | $73.70 | $73.70 | $73.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $8,220.00 / $14,242.22
| Facility | | $4,062.00 | $8,220.00 | $14,242.22 |