- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $2,691.53 / $7,585.78
| Facility | | $1,819.70 | $2,691.53 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $151.36 / $2,454.71
| Facility | | $100.00 | $151.36 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $501.19 / $2,511.89
| Facility | | $407.38 | $501.19 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $323.59 / $323.59 / $323.59
| Facility | 52 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $40.74 / $40.74 / $40.74
| Facility | AS | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $1,479.11 / $1,479.11
| Facility | | $54.95 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | 52 | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.91 / $147.91 / $147.91
| Facility | AS | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,454.71 / $4,677.35
| Facility | | $1,023.29 | $2,454.71 | $4,677.35 |