- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,282.83 / $3,534.75 / $10,234.00
| Facility | | $1,282.83 | $3,534.75 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $288.42 / $413.82 / $873.88
| Facility | 52 | $288.42 | $413.82 | $873.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,660.00 / $7,133.00 / $13,498.00
| Facility | | $3,660.00 | $7,133.00 | $13,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,271.89 / $27,770.10 / $27,770.10
| Facility | | $4,271.89 | $27,770.10 | $27,770.10 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,355.42 / $21,057.68 / $21,057.68
| Facility | 52 | $1,355.42 | $21,057.68 | $21,057.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.43 / $2,632.21 / $2,632.21
| Facility | AS | $169.43 | $2,632.21 | $2,632.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,959.00 / $8,273.00 / $12,407.00
| Facility | | $3,959.00 | $8,273.00 | $12,407.00 |