- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $738.78 / $5,219.64
| Facility | | $100.00 | $738.78 | $5,219.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,550.00 / $29,500.00 / $35,000.00
| Facility | | $26,550.00 | $29,500.00 | $35,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.12 / $450.12 / $450.12
| Facility | | $450.12 | $450.12 | $450.12 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $276.13 / $276.13 / $276.13
| Facility | 62 | $276.13 | $276.13 | $276.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $44.18 / $44.18 / $44.18
| Facility | AS | $44.18 | $44.18 | $44.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,155.00 / $11,155.00 / $11,155.00
| Facility | | $11,155.00 | $11,155.00 | $11,155.00 |