- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,201.03 / $6,251.00 / $11,581.00
| Facility | | $2,201.03 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,405.00 / $16,655.00 / $29,882.70
| Facility | | $3,405.00 | $16,655.00 | $29,882.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,353.91 / $1,477.00 / $2,150.71
| Facility | | $1,353.91 | $1,477.00 | $2,150.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,720.92 / $1,720.92 / $1,720.92
| Facility | | $1,720.92 | $1,720.92 | $1,720.92 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,069.99 / $1,069.99 / $1,069.99
| Facility | 62 | $1,069.99 | $1,069.99 | $1,069.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.20 / $171.20 / $171.20
| Facility | AS | $171.20 | $171.20 | $171.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |