- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,818.59 / $5,699.00 / $14,259.00
| Facility | | $1,818.59 | $5,699.00 | $14,259.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $717.17 / $921.74 / $1,352.75
| Facility | 52 | $717.17 | $921.74 | $1,352.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,574.00 / $7,506.00 / $14,226.00
| Facility | | $4,574.00 | $7,506.00 | $14,226.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,159.31 / $2,159.31 / $37,499.62
| Facility | | $2,159.31 | $2,159.31 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,742.51 / $1,742.51 / $7,227.90
| Facility | | $1,742.51 | $1,742.51 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,366.02 / $1,366.02 / $1,366.02
| Facility | 52 | $1,366.02 | $1,366.02 | $1,366.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $170.75 / $170.75 / $170.75
| Facility | AS | $170.75 | $170.75 | $170.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $2,276.00 / $4,050.23
| Facility | | $332.00 | $2,276.00 | $4,050.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,415.98 / $1,415.98 / $1,415.98
| Facility | | $1,415.98 | $1,415.98 | $1,415.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,086.08 / $20,086.08 / $20,086.08
| Facility | | $20,086.08 | $20,086.08 | $20,086.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,742.51 / $12,209.00
| Facility | | $597.00 | $1,742.51 | $12,209.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,366.02 / $1,366.02 / $1,366.02
| Facility | 52 | $1,366.02 | $1,366.02 | $1,366.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $170.75 / $170.75 / $170.75
| Facility | AS | $170.75 | $170.75 | $170.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,092.00 / $5,547.00 / $13,746.00
| Facility | | $2,092.00 | $5,547.00 | $13,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,812.85 / $1,812.85 / $5,924.04
| Facility | | $1,812.85 | $1,812.85 | $5,924.04 |