- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $24,068.03
| Facility | | $4,241.22 | $10,431.19 | $24,068.03 |
- 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
- $1,136.21 / $1,988.37 / $9,696.00
| Facility | | $1,136.21 | $1,988.37 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,007.47 / $3,781.71 / $3,781.71
| Facility | 62 | $2,007.47 | $3,781.71 | $3,781.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $321.20 / $605.07 / $605.07
| Facility | AS | $321.20 | $605.07 | $605.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,453.35 / $2,838.83 / $3,984.45
| Facility | | $1,453.35 | $2,838.83 | $3,984.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |