- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $4,677.35 / $10,715.19
| Facility | | $338.84 | $4,677.35 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $5,011.87 / $19,498.45
| Facility | | $2,238.72 | $5,011.87 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $20,417.38
| Facility | | $10,964.78 | $16,982.44 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $562.34 / $9,120.11
| Facility | | $302.00 | $562.34 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $489.78 / $912.01 / $912.01
| Facility | 62 | $489.78 | $912.01 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $77.62 / $147.91 / $147.91
| Facility | AS | $77.62 | $147.91 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,630.78 / $11,748.98
| Facility | | $2,884.03 | $3,630.78 | $11,748.98 |