- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $342.13 / $342.13 / $342.13
| Facility | 52 | $342.13 | $342.13 | $342.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.80 / $9,302.56 / $16,325.39
| Facility | | $6,416.80 | $9,302.56 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.26 / $1,163.24 / $1,855.74
| Facility | | $684.26 | $1,163.24 | $1,855.74 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $2,816.91 / $2,816.91 / $2,816.91
| Facility | 52 | $2,816.91 | $2,816.91 | $2,816.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $352.11 / $352.11 / $352.11
| Facility | AS | $352.11 | $352.11 | $352.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.00 / $1,692.86 / $2,382.19
| Facility | | $1,232.00 | $1,692.86 | $2,382.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |