- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,621.81 / $5,623.41 / $13,803.84
| Facility | | $1,621.81 | $5,623.41 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,951.21 / $4,466.84 / $12,589.25
| Facility | 52 | $2,951.21 | $4,466.84 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $11,220.18 / $22,387.21
| Facility | | $3,890.45 | $11,220.18 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $2,630.27 / $10,471.29
| Facility | | $457.09 | $2,630.27 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | 52 | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,888.44 / $14,791.08
| Facility | | $1,778.28 | $5,888.44 | $14,791.08 |