- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,130.04 / $4,887.20 / $16,467.00
| Facility | | $2,130.04 | $4,887.20 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,065.02 / $2,443.60 / $2,443.60
| Facility | 52 | $1,065.02 | $2,443.60 | $2,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $560.00 / $615.00
| Facility | | $100.00 | $560.00 | $615.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,615.65 / $1,615.65 / $1,615.65
| Facility | 52 | $1,615.65 | $1,615.65 | $1,615.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $201.96 / $201.96 / $201.96
| Facility | AS | $201.96 | $201.96 | $201.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,539.17 / $2,074.00 / $3,632.70
| Facility | | $1,539.17 | $2,074.00 | $3,632.70 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $294.00 / $355.60 / $663.26
| Facility | 80 | $294.00 | $355.60 | $663.26 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $205.80 / $250.13 / $464.28
| Facility | AS | $205.80 | $250.13 | $464.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.00 / $6,074.00 / $8,818.00
| Facility | | $454.00 | $6,074.00 | $8,818.00 |