- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,677.35 / $8,317.64
| Facility | | $2,041.74 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,370.32 / $7,943.28
| Facility | | $1,659.59 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $2,754.23 / $8,128.31
| Facility | | $1,778.28 | $2,754.23 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $3,801.89 / $6,918.31 / $6,918.31
| Facility | 52 | $3,801.89 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $478.63 / $851.14 / $851.14
| Facility | AS | $478.63 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,623.41 / $8,709.64
| Facility | | $4,168.69 | $5,623.41 | $8,709.64 |