- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $3,388.44 / $8,511.38
| Facility | | $416.87 | $3,388.44 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,981.07 / $3,981.07 / $4,570.88
| Facility | 52 | $3,981.07 | $3,981.07 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $4,897.79 / $10,471.29
| Facility | | $1,621.81 | $4,897.79 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $676.08 / $1,659.59
| Facility | | $338.84 | $676.08 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | 52 | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 53
- Low / Median / High Price
- $67.61 / $67.61 / $67.61
| Facility | 53 | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $208.93 / $208.93 / $208.93
| Facility | 62 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $33.88 / $33.88 / $33.88
| Facility | AS | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,630.27 / $6,309.57
| Facility | | $660.69 | $2,630.27 | $6,309.57 |