- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.00 / $6,821.00 / $13,260.00
| Facility | | $1,026.00 | $6,821.00 | $13,260.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $443.30 / $480.72 / $521.35
| Facility | 52 | $443.30 | $480.72 | $521.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $11,502.00 / $30,357.00
| Facility | | $400.00 | $11,502.00 | $30,357.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $959.49 / $959.49 / $959.49
| Facility | 52 | $959.49 | $959.49 | $959.49 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.94 / $119.94 / $119.94
| Facility | AS | $119.94 | $119.94 | $119.94 |
- 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
- $2,620.00 / $10,236.00 / $15,888.00
| Facility | | $2,620.00 | $10,236.00 | $15,888.00 |