- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.16 / $12,883.29 / $24,185.23
| Facility | | $9,506.16 | $12,883.29 | $24,185.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,466.44 / $4,316.29 / $8,632.00
| Facility | | $2,466.44 | $4,316.29 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $7,746.01 / $7,746.01 / $7,746.01
| Facility | 62 | $7,746.01 | $7,746.01 | $7,746.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,239.35 / $1,239.35 / $1,239.35
| Facility | AS | $1,239.35 | $1,239.35 | $1,239.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,641.00 / $6,128.10 / $8,391.68
| Facility | | $4,641.00 | $6,128.10 | $8,391.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,080.11 / $6,178.00 / $8,816.00
| Facility | | $2,080.11 | $6,178.00 | $8,816.00 |