- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,742.00 / $18,600.00
| Facility | | $1,000.00 | $3,742.00 | $18,600.00 |
- 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
- $341.16 / $494.94 / $10,232.00
| Facility | | $341.16 | $494.94 | $10,232.00 |
- 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
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |