- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.24 / $945.46 / $9,311.00
| Facility | | $740.24 | $945.46 | $9,311.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $370.12 / $392.23 / $472.73
| Facility | 52 | $370.12 | $392.23 | $472.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.42 / $998.41 / $1,151.74
| Facility | | $727.42 | $998.41 | $1,151.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.09 / $875.09 / $875.09
| Facility | | $875.09 | $875.09 | $875.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $688.97 / $688.97 / $688.97
| Facility | 52 | $688.97 | $688.97 | $688.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $86.12 / $86.12 / $86.12
| Facility | AS | $86.12 | $86.12 | $86.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $1,121.00 / $8,582.00
| Facility | | $631.00 | $1,121.00 | $8,582.00 |