- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.50 / $4,261.00 / $10,043.00
| Facility | | $1,044.50 | $4,261.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $354.84 / $354.84 / $464.37
| Facility | 52 | $354.84 | $354.84 | $464.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $4,319.00 / $10,043.00
| Facility | | $2,234.00 | $4,319.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,530.00 / $2,530.00 / $2,530.00
| Facility | | $2,530.00 | $2,530.00 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.24 / $1,161.04 / $3,064.00
| Facility | | $710.24 | $1,161.04 | $3,064.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,529.43 / $2,816.91 / $2,816.91
| Facility | 52 | $1,529.43 | $2,816.91 | $2,816.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.18 / $352.11 / $352.11
| Facility | AS | $191.18 | $352.11 | $352.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,829.00 / $3,700.00 / $6,653.00
| Facility | | $1,829.00 | $3,700.00 | $6,653.00 |