- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $4,790.00 / $11,576.00
| Facility | | $1,500.00 | $4,790.00 | $11,576.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $767.23 / $819.01 / $908.12
| Facility | 52 | $767.23 | $819.01 | $908.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $500.00 / $5,695.32
| Facility | | $400.00 | $500.00 | $5,695.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,648.76 / $1,648.76 / $1,648.76
| Facility | 52 | $1,648.76 | $1,648.76 | $1,648.76 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $206.10 / $206.10 / $206.10
| Facility | AS | $206.10 | $206.10 | $206.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $19,859.00 / $31,911.00
| Facility | | $6,600.00 | $19,859.00 | $31,911.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.94 / $4,367.00 / $11,244.00
| Facility | | $615.94 | $4,367.00 | $11,244.00 |