- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,384.96 / $3,604.35 / $19,514.75
| Facility | | $1,384.96 | $3,604.35 | $19,514.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,216.00 / $10,266.00 / $16,534.00
| Facility | | $5,216.00 | $10,266.00 | $16,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,361.40 / $79,615.70 / $79,615.70
| Facility | | $13,361.40 | $79,615.70 | $79,615.70 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,441.19 / $47,165.25 / $47,165.25
| Facility | 62 | $2,441.19 | $47,165.25 | $47,165.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $390.59 / $7,546.44 / $7,546.44
| Facility | AS | $390.59 | $7,546.44 | $7,546.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $8,273.00 / $12,407.00
| Facility | | $3,964.00 | $8,273.00 | $12,407.00 |