- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.41 / $1,424.00 / $2,816.16
| Facility | | $1,141.41 | $1,424.00 | $2,816.16 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,456.48 / $4,525.71 / $4,525.71
| Facility | 52 | $2,456.48 | $4,525.71 | $4,525.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $307.06 / $565.71 / $565.71
| Facility | AS | $307.06 | $565.71 | $565.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.00 / $2,572.00 / $14,572.00
| Facility | | $175.00 | $2,572.00 | $14,572.00 |