- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $3,715.35 / $7,585.78
| Facility | | $562.34 | $3,715.35 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $3,981.07
| Facility | | $831.76 | $2,691.53 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $467.74 / $9,332.54
| Facility | | $302.00 | $467.74 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $489.78 / $489.78 / $912.01
| Facility | 62 | $489.78 | $489.78 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $77.62 / $77.62 / $147.91
| Facility | AS | $77.62 | $77.62 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $7,244.36 / $14,125.38
| Facility | | $5,248.07 | $7,244.36 | $14,125.38 |