- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,971.69 / $8,023.32 / $20,928.72
| Facility | | $3,971.69 | $8,023.32 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $548.08 / $548.08 / $548.08
| Facility | 52 | $548.08 | $548.08 | $548.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,646.56 / $11,718.32 / $21,998.27
| Facility | | $8,646.56 | $11,718.32 | $21,998.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.16 / $2,988.59 / $17,344.45
| Facility | | $1,096.16 | $2,988.59 | $17,344.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $16,840.24 / $16,840.24 / $16,840.24
| Facility | 52 | $16,840.24 | $16,840.24 | $16,840.24 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $13,156.44 / $13,156.44 / $13,156.44
| Facility | 62 | $13,156.44 | $13,156.44 | $13,156.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,105.03 / $2,105.03 / $2,105.03
| Facility | AS | $2,105.03 | $2,105.03 | $2,105.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,210.13 / $2,947.84 / $4,406.46
| Facility | | $2,210.13 | $2,947.84 | $4,406.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |