- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $3,684.00 / $18,600.00
| Facility | | $1,346.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.71 / $17,815.62 / $28,366.81
| Facility | | $11,271.71 | $17,815.62 | $28,366.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,746.38 / $2,830.64 / $9,412.67
| Facility | | $1,746.38 | $2,830.64 | $9,412.67 |
- 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
- $1,280.00 / $5,524.00 / $9,232.95
| Facility | | $1,280.00 | $5,524.00 | $9,232.95 |