- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,330.06 / $4,928.00 / $16,400.00
| Facility | | $1,330.06 | $4,928.00 | $16,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.76 / $15,004.39 / $23,706.76
| Facility | | $9,444.76 | $15,004.39 | $23,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,330.06 / $1,791.10 / $16,419.37
| Facility | | $1,330.06 | $1,791.10 | $16,419.37 |
- 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
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |