- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $4,897.79 / $10,964.78
| Facility | | $954.99 | $4,897.79 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $501.19 / $3,311.31
| Facility | | $323.59 | $501.19 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $1,412.54 / $1,412.54 / $1,412.54
| Facility | 52 | $1,412.54 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.83 / $177.83 / $177.83
| Facility | AS | $177.83 | $177.83 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $20,892.96 / $33,113.11
| Facility | | $7,943.28 | $20,892.96 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $5,011.87 / $10,715.19
| Facility | | $616.60 | $5,011.87 | $10,715.19 |