- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.89 / $10,255.42 / $23,483.17
| Facility | | $3,474.89 | $10,255.42 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.45 / $1,964.29 / $9,696.00
| Facility | | $1,122.45 | $1,964.29 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,983.87 / $3,722.09 / $3,722.09
| Facility | 62 | $1,983.87 | $3,722.09 | $3,722.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $317.42 / $595.54 / $595.54
| Facility | AS | $317.42 | $595.54 | $595.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,432.09 / $2,803.17 / $3,955.47
| Facility | | $1,432.09 | $2,803.17 | $3,955.47 |
- 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 |