- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $2,562.00 / $3,884.00
| Facility | | $900.00 | $2,562.00 | $3,884.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $752.05 / $773.12 / $860.85
| Facility | 52 | $752.05 | $773.12 | $860.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,955.12 / $5,133.70 / $7,741.01
| Facility | | $2,955.12 | $5,133.70 | $7,741.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $952.06 / $952.06
| Facility | | $40.00 | $952.06 | $952.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $675.00 / $1,187.10
| Facility | | $488.00 | $675.00 | $1,187.10 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $931.75 / $931.75 / $931.75
| Facility | 52 | $931.75 | $931.75 | $931.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $116.47 / $116.47 / $116.47
| Facility | AS | $116.47 | $116.47 | $116.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $1,261.00 / $7,168.00
| Facility | | $385.00 | $1,261.00 | $7,168.00 |