- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $281.06 / $8,477.27 / $20,928.72
| Facility | | $281.06 | $8,477.27 | $20,928.72 |
- 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
- $281.06 / $519.96 / $5,180.28
| Facility | | $281.06 | $519.96 | $5,180.28 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $486.75 / $919.65 / $919.65
| Facility | 62 | $486.75 | $919.65 | $919.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $77.88 / $147.13 / $147.13
| Facility | AS | $77.88 | $147.13 | $147.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.36 / $707.42 / $1,001.13
| Facility | | $375.36 | $707.42 | $1,001.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |