- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,718.25 / $13,170.73 / $24,724.83
| Facility | | $9,718.25 | $13,170.73 | $24,724.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,846.47 / $3,266.40 / $8,632.00
| Facility | | $1,846.47 | $3,266.40 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $6,866.68 / $6,866.68 / $6,866.68
| Facility | 52 | $6,866.68 | $6,866.68 | $6,866.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $858.34 / $858.34 / $858.34
| Facility | AS | $858.34 | $858.34 | $858.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $4,126.60 / $5,817.97
| Facility | | $3,044.00 | $4,126.60 | $5,817.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |