- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,521.00 / $10,407.00
| Facility | | $2,073.00 | $4,521.00 | $10,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,640.00 / $10,860.55
| Facility | | $1,763.75 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,232.21 / $1,605.66 / $15,169.00
| Facility | | $1,232.21 | $1,605.66 | $15,169.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,983.87 / $1,983.87 / $3,722.09
| Facility | 62 | $1,983.87 | $1,983.87 | $3,722.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $317.42 / $317.42 / $595.54
| Facility | AS | $317.42 | $317.42 | $595.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,560.00 / $10,316.00 / $16,841.00
| Facility | | $3,560.00 | $10,316.00 | $16,841.00 |