- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,923.23 / $24,068.03
| Facility | | $5,463.36 | $11,923.23 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $303.77 / $303.77 / $303.77
| Facility | 52 | $303.77 | $303.77 | $303.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.80 / $8,696.41 / $16,325.39
| Facility | | $6,416.80 | $8,696.41 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.64 / $1,420.90 / $17,344.45
| Facility | | $774.64 | $1,420.90 | $17,344.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $21,057.68 / $21,057.68 / $21,057.68
| Facility | 52 | $21,057.68 | $21,057.68 | $21,057.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,632.21 / $2,632.21 / $2,632.21
| Facility | AS | $2,632.21 | $2,632.21 | $2,632.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.54 / $1,758.25 / $8,854.25
| Facility | | $1,225.54 | $1,758.25 | $8,854.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |