- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,637.81 / $5,960.00 / $13,407.00
| Facility | | $1,637.81 | $5,960.00 | $13,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,527.00 / $7,797.00 / $15,052.00
| Facility | | $4,527.00 | $7,797.00 | $15,052.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,809.95 / $5,511.50 / $16,534.50
| Facility | | $1,809.95 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,486.82 / $1,486.82 / $1,486.82
| Facility | | $1,486.82 | $1,486.82 | $1,486.82 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $925.06 / $925.06 / $925.06
| Facility | 62 | $925.06 | $925.06 | $925.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.01 / $148.01 / $148.01
| Facility | AS | $148.01 | $148.01 | $148.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,708.00 / $3,632.92
| Facility | | $332.00 | $1,708.00 | $3,632.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,213.19 / $1,213.19 / $1,213.19
| Facility | | $1,213.19 | $1,213.19 | $1,213.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,134.74 / $3,134.74 / $3,134.74
| Facility | | $3,134.74 | $3,134.74 | $3,134.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $597.00 / $37,776.00
| Facility | | $555.00 | $597.00 | $37,776.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $925.06 / $925.06 / $925.06
| Facility | 62 | $925.06 | $925.06 | $925.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.01 / $148.01 / $148.01
| Facility | AS | $148.01 | $148.01 | $148.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,673.00 / $7,719.00 / $18,532.00
| Facility | | $2,673.00 | $7,719.00 | $18,532.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,181.42 / $2,181.42 / $5,391.43
| Facility | | $2,181.42 | $2,181.42 | $5,391.43 |