- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,886.39 / $17,746.75 / $20,792.81
| Facility | | $1,886.39 | $17,746.75 | $20,792.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,679.02 / $2,014.82 / $2,518.53
| Facility | | $1,679.02 | $2,014.82 | $2,518.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,938.95 / $1,938.95 / $1,938.95
| Facility | | $1,938.95 | $1,938.95 | $1,938.95 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,200.02 / $1,200.02 / $1,200.02
| Facility | 62 | $1,200.02 | $1,200.02 | $1,200.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $192.00 / $192.00 / $192.00
| Facility | AS | $192.00 | $192.00 | $192.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,230.37 / $22,087.14 / $60,529.42
| Facility | | $16,230.37 | $22,087.14 | $60,529.42 |