- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.00 / $3,034.00 / $11,857.57
| Facility | | $1,038.00 | $3,034.00 | $11,857.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.30 / $3,321.60 / $5,432.89
| Facility | | $882.30 | $3,321.60 | $5,432.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.82 / $459.22 / $1,868.00
| Facility | | $338.82 | $459.22 | $1,868.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $541.86 / $541.86 / $1,025.63
| Facility | 62 | $541.86 | $541.86 | $1,025.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $86.70 / $86.70 / $164.10
| Facility | AS | $86.70 | $86.70 | $164.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.00 / $1,535.00 / $2,175.00
| Facility | | $716.00 | $1,535.00 | $2,175.00 |