- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $4,677.35 / $11,481.54
| Facility | | $1,412.54 | $4,677.35 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $32,359.37
| Facility | 52 | $32,359.37 | $32,359.37 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $9,332.54 / $17,378.01
| Facility | | $3,388.44 | $9,332.54 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $2,290.87 / $5,623.41
| Facility | | $398.11 | $2,290.87 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | 22 | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 52 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Facility | AS | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,818.38 / $9,772.37
| Facility | | $537.03 | $2,818.38 | $9,772.37 |