- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $6,918.31 / $14,454.40
| Facility | | $1,230.27 | $6,918.31 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $13,182.57
| Facility | 52 | $10,964.78 | $10,964.78 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,309.57 / $12,589.25
| Facility | | $2,818.38 | $6,309.57 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,589.25 / $14,791.08
| Facility | | $4,365.16 | $12,589.25 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,122.02 / $10,232.93
| Facility | | $691.83 | $1,122.02 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,412.54 / $12,302.69 / $12,302.69
| Facility | 52 | $1,412.54 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.83 / $1,548.82 / $1,548.82
| Facility | AS | $177.83 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,466.84 / $11,481.54
| Facility | | $2,884.03 | $4,466.84 | $11,481.54 |