- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,100.08 / $24,068.03
| Facility | | $4,241.22 | $11,100.08 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.78 / $2,356.87 / $9,815.00
| Facility | | $1,346.78 | $2,356.87 | $9,815.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,353.94 / $4,380.60 / $4,380.60
| Facility | 62 | $2,353.94 | $4,380.60 | $4,380.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $376.63 / $700.90 / $700.90
| Facility | AS | $376.63 | $700.90 | $700.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,762.49 / $3,369.69 / $4,728.22
| Facility | | $1,762.49 | $3,369.69 | $4,728.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |