- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,134.81 / $3,651.00 / $9,765.66
| Facility | | $2,134.81 | $3,651.00 | $9,765.66 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $324.12 / $324.12 / $5,293.51
| Facility | 52 | $324.12 | $324.12 | $5,293.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.04 / $6,078.00 / $26,542.00
| Facility | | $1,534.04 | $6,078.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,355.42 / $1,355.42 / $21,057.68
| Facility | 52 | $1,355.42 | $1,355.42 | $21,057.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.43 / $169.43 / $2,632.21
| Facility | AS | $169.43 | $169.43 | $2,632.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.16 / $1,389.32 / $6,679.00
| Facility | | $652.16 | $1,389.32 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $915.63 / $8,930.84 / $23,893.03
| Facility | | $915.63 | $8,930.84 | $23,893.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $7,292.00 / $26,542.00
| Facility | | $2,386.00 | $7,292.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,355.42 / $1,355.42 / $21,057.68
| Facility | 52 | $1,355.42 | $1,355.42 | $21,057.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.43 / $169.43 / $2,632.21
| Facility | AS | $169.43 | $169.43 | $2,632.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,386.00 / $5,904.00 / $13,017.00
| Facility | | $2,386.00 | $5,904.00 | $13,017.00 |