- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,515.14 / $2,575.73 / $17,453.65
| Facility | | $1,515.14 | $2,575.73 | $17,453.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,013.68 / $32,422.94 / $66,228.75
| Facility | | $3,013.68 | $32,422.94 | $66,228.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,662.80 / $5,196.99 / $12,502.05
| Facility | | $3,662.80 | $5,196.99 | $12,502.05 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,113.57 / $1,113.57 / $1,113.57
| Facility | 62 | $1,113.57 | $1,113.57 | $1,113.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $178.17 / $178.17 / $178.17
| Facility | AS | $178.17 | $178.17 | $178.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,329.82 / $4,751.29 / $9,844.14
| Facility | | $3,329.82 | $4,751.29 | $9,844.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,603.36 / $2,622.75 / $7,241.12
| Facility | | $1,603.36 | $2,622.75 | $7,241.12 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,441.19 / $2,441.19 / $2,441.19
| Facility | 62 | $2,441.19 | $2,441.19 | $2,441.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $390.59 / $390.59 / $390.59
| Facility | AS | $390.59 | $390.59 | $390.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |