- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,456.83 / $5,324.00 / $11,996.00
| Facility | | $2,456.83 | $5,324.00 | $11,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,584.00 / $9,521.00 / $22,591.00
| Facility | | $4,584.00 | $9,521.00 | $22,591.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,846.49 / $3,846.49 / $37,499.62
| Facility | | $3,846.49 | $3,846.49 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.37 / $3,066.37 / $7,227.90
| Facility | | $3,066.37 | $3,066.37 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,892.76 / $1,892.76 / $1,892.76
| Facility | 62 | $1,892.76 | $1,892.76 | $1,892.76 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $302.83 / $302.83 / $302.83
| Facility | AS | $302.83 | $302.83 | $302.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $4,625.10 / $8,650.00
| Facility | | $332.00 | $4,625.10 | $8,650.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $20.43 / $20.43 / $20.43
| Facility | 50 | $20.43 | $20.43 | $20.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $3,066.37 / $23,610.00
| Facility | | $597.00 | $3,066.37 | $23,610.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,892.76 / $1,892.76 / $1,892.76
| Facility | 62 | $1,892.76 | $1,892.76 | $1,892.76 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $302.83 / $302.83 / $302.83
| Facility | AS | $302.83 | $302.83 | $302.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,311.23 / $5,547.00 / $32,490.00
| Facility | | $2,311.23 | $5,547.00 | $32,490.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,893.46 / $2,893.46 / $9,132.48
| Facility | | $2,893.46 | $2,893.46 | $9,132.48 |