- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.92 / $5,710.00 / $12,051.00
| Facility | | $1,567.92 | $5,710.00 | $12,051.00 |
- 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
- $1,782.27 / $5,511.50 / $16,534.50
| Facility | | $1,782.27 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,463.39 / $1,463.39 / $1,463.39
| Facility | | $1,463.39 | $1,463.39 | $1,463.39 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $908.75 / $908.75 / $908.75
| Facility | 62 | $908.75 | $908.75 | $908.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $145.40 / $145.40 / $145.40
| Facility | AS | $145.40 | $145.40 | $145.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,690.00 / $3,563.03
| Facility | | $332.00 | $1,690.00 | $3,563.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.83 / $1,195.83 / $1,195.83
| Facility | | $1,195.83 | $1,195.83 | $1,195.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,614.31 / $1,614.31 / $1,614.31
| Facility | | $1,614.31 | $1,614.31 | $1,614.31 |
- 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
- $908.75 / $908.75 / $908.75
| Facility | 62 | $908.75 | $908.75 | $908.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $145.40 / $145.40 / $145.40
| Facility | AS | $145.40 | $145.40 | $145.40 |
- 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
- $2,146.73 / $2,146.73 / $5,381.38
| Facility | | $2,146.73 | $2,146.73 | $5,381.38 |