- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,590.91 / $2,747.00 / $4,806.64
| Facility | | $1,590.91 | $2,747.00 | $4,806.64 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $795.46 / $795.46 / $795.46
| Facility | 52 | $795.46 | $795.46 | $795.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,854.00 / $14,827.68
| Facility | | $55.00 | $2,854.00 | $14,827.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,265.50 / $6,344.41 / $6,344.41
| Facility | 52 | $3,265.50 | $6,344.41 | $6,344.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $408.19 / $793.05 / $793.05
| Facility | AS | $408.19 | $793.05 | $793.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.00 / $680.00 / $748.00
| Facility | | $50.00 | $680.00 | $748.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $2,533.17 / $6,679.00
| Facility | | $300.00 | $2,533.17 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,446.00 / $14,827.68
| Facility | | $55.00 | $2,446.00 | $14,827.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,265.50 / $6,344.41 / $6,344.41
| Facility | 52 | $3,265.50 | $6,344.41 | $6,344.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $408.19 / $793.05 / $793.05
| Facility | AS | $408.19 | $793.05 | $793.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $2,446.00 / $4,050.00
| Facility | | $789.00 | $2,446.00 | $4,050.00 |