- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,822.86 / $15,307.00 / $35,003.69
| Facility | | $1,822.86 | $15,307.00 | $35,003.69 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $379.17 / $379.17 / $911.43
| Facility | 52 | $379.17 | $379.17 | $911.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,134.26 / $16,155.56 / $28,242.50
| Facility | | $4,134.26 | $16,155.56 | $28,242.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,229.55 / $6,229.55 / $8,005.08
| Facility | | $6,229.55 | $6,229.55 | $8,005.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.43 / $947.93 / $1,503.35
| Facility | | $748.43 | $947.93 | $1,503.35 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $179.80 / $212.61 / $281.00
| Facility | 80 | $179.80 | $212.61 | $281.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.11 / $148.83 / $196.70
| Facility | AS | $125.11 | $148.83 | $196.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |