- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.19 / $5,350.00 / $38,474.50
| Facility | | $1,653.19 | $5,350.00 | $38,474.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,799.47 / $1,799.47 / $1,799.47
| Facility | | $1,799.47 | $1,799.47 | $1,799.47 |
- 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
- $9,919.68 / $38,844.54 / $115,565.81
| Facility | | $9,919.68 | $38,844.54 | $115,565.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,544.00 / $6,029.00 / $27,771.29
| Facility | | $1,544.00 | $6,029.00 | $27,771.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,799.47 / $1,799.47 / $1,799.47
| Facility | | $1,799.47 | $1,799.47 | $1,799.47 |
- 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
- $1,549.82 / $1,549.82 / $1,549.82
| Facility | | $1,549.82 | $1,549.82 | $1,549.82 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,534.98 / $1,534.98 / $1,534.98
| Facility | 62 | $1,534.98 | $1,534.98 | $1,534.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |