- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $536.00 / $2,705.50 / $6,924.24
| Facility | | $536.00 | $2,705.50 | $6,924.24 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $8,784.43 / $8,784.43 / $8,784.43
| Facility | 62 | $8,784.43 | $8,784.43 | $8,784.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- 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
- $1,100.96 / $1,660.26 / $4,095.73
| Facility | | $1,100.96 | $1,660.26 | $4,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $472.96 / $2,266.00 / $7,197.00
| Facility | | $472.96 | $2,266.00 | $7,197.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $8,784.43 / $8,784.43 / $8,784.43
| Facility | 62 | $8,784.43 | $8,784.43 | $8,784.43 |
- 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
- $385.93 / $385.93 / $475.51
| Facility | | $385.93 | $385.93 | $475.51 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $377.50 / $377.50 / $377.50
| Facility | 62 | $377.50 | $377.50 | $377.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |