- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $3,715.35 / $11,481.54
| Facility | | $1,949.84 | $3,715.35 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,370.32 / $9,772.37
| Facility | | $1,174.90 | $5,370.32 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | 52 | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Facility | AS | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50.12 / $676.08 / $1,380.38
| Facility | | $50.12 | $676.08 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $1,995.26 / $7,079.46
| Facility | | $707.95 | $1,995.26 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $5,011.87 / $13,182.57
| Facility | | $776.25 | $5,011.87 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,370.32 / $9,772.37
| Facility | | $1,174.90 | $5,370.32 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $7,762.47 / $7,762.47 / $7,762.47
| Facility | 52 | $7,762.47 | $7,762.47 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $977.24 / $977.24 / $977.24
| Facility | AS | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,890.45 / $12,882.50
| Facility | | $977.24 | $3,890.45 | $12,882.50 |