- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.40 / $3,100.51 / $5,432.89
| Facility | | $830.40 | $3,100.51 | $5,432.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $224.22 / $290.27 / $1,424.00
| Facility | | $224.22 | $290.27 | $1,424.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $467.15 / $868.31 / $868.31
| Facility | 52 | $467.15 | $868.31 | $868.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $58.39 / $108.54 / $108.54
| Facility | AS | $58.39 | $108.54 | $108.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.00 / $2,572.00 / $14,572.00
| Facility | | $175.00 | $2,572.00 | $14,572.00 |