- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,156.46 / $5,404.00 / $15,702.00
| Facility | | $1,156.46 | $5,404.00 | $15,702.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $318.13 / $318.13 / $318.13
| Facility | 52 | $318.13 | $318.13 | $318.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.83 / $13,548.97 / $21,558.31
| Facility | | $8,588.83 | $13,548.97 | $21,558.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $636.25 / $1,509.81 / $14,587.03
| Facility | | $636.25 | $1,509.81 | $14,587.03 |
- 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
- $1,570.00 / $6,980.00 / $13,541.98
| Facility | | $1,570.00 | $6,980.00 | $13,541.98 |