- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $20,928.72
| Facility | | $5,463.36 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $667.54 / $667.54 / $667.54
| Facility | 52 | $667.54 | $667.54 | $667.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,904.89 / $9,357.90 / $17,567.16
| Facility | | $6,904.89 | $9,357.90 | $17,567.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,428.33 / $2,536.63 / $7,772.00
| Facility | | $1,428.33 | $2,536.63 | $7,772.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $6,567.00 / $6,567.00 / $6,567.00
| Facility | 50 | $6,567.00 | $6,567.00 | $6,567.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $5,298.36 / $5,298.36 / $5,298.36
| Facility | 52 | $5,298.36 | $5,298.36 | $5,298.36 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $4,139.34 / $4,139.34 / $4,139.34
| Facility | 62 | $4,139.34 | $4,139.34 | $4,139.34 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $662.30 / $662.30 / $662.30
| Facility | AS | $662.30 | $662.30 | $662.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,219.00 / $3,184.11 / $4,344.59
| Facility | | $2,219.00 | $3,184.11 | $4,344.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |