- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,495.41 / $10,000.00
| Facility | | $1,819.70 | $5,495.41 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $10,471.29 / $19,498.45
| Facility | | $2,344.23 | $10,471.29 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $17,378.01 / $20,417.38
| Facility | | $7,943.28 | $17,378.01 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $2,691.53 / $44,668.36
| Facility | | $1,479.11 | $2,691.53 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,454.71 / $46,773.51 / $46,773.51
| Facility | 62 | $2,454.71 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $389.05 / $7,585.78 / $7,585.78
| Facility | AS | $389.05 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,128.61 / $15,848.93
| Facility | | $2,884.03 | $5,128.61 | $15,848.93 |