- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,372.33 / $1,372.33 / $2,091.25
| Facility | | $1,372.33 | $1,372.33 | $2,091.25 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $686.17 / $686.17 / $1,045.63
| Facility | 52 | $686.17 | $686.17 | $1,045.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.63 / $1,619.52 / $1,764.49
| Facility | | $1,424.63 | $1,619.52 | $1,764.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,526.26 / $1,526.26 / $1,526.26
| Facility | | $1,526.26 | $1,526.26 | $1,526.26 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,198.39 / $1,198.39 / $1,198.39
| Facility | 52 | $1,198.39 | $1,198.39 | $1,198.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $149.80 / $149.80 / $149.80
| Facility | AS | $149.80 | $149.80 | $149.80 |