- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,928.00 / $16,400.00
| Facility | | $1,346.00 | $4,928.00 | $16,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.76 / $15,004.39 / $23,706.76
| Facility | | $9,444.76 | $15,004.39 | $23,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,603.64 / $2,216.58 / $17,345.00
| Facility | | $1,603.64 | $2,216.58 | $17,345.00 |
- 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
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |