- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,511.89 / $7,413.10
| Facility | | $436.52 | $2,511.89 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $10,471.29 / $19,498.45
| Facility | | $2,344.23 | $10,471.29 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $17,378.01 / $20,417.38
| Facility | | $7,943.28 | $17,378.01 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $691.83 / $9,120.11
| Facility | | $380.19 | $691.83 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $588.84 / $1,122.02 / $1,122.02
| Facility | 62 | $588.84 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $95.50 / $181.97 / $181.97
| Facility | AS | $95.50 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,311.31 / $10,964.78
| Facility | | $2,454.71 | $3,311.31 | $10,964.78 |