- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.04 / $565.40 / $1,775.00
| Facility | | $311.04 | $565.40 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $541.86 / $1,025.63 / $1,025.63
| Facility | 62 | $541.86 | $1,025.63 | $1,025.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $86.70 / $164.10 / $164.10
| Facility | AS | $86.70 | $164.10 | $164.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.40 / $788.94 / $1,104.36
| Facility | | $412.40 | $788.94 | $1,104.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |