- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $4,677.35 / $13,182.57
| Facility | | $1,819.70 | $4,677.35 | $13,182.57 |
- 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
- $1,288.25 / $2,818.38 / $15,488.17
| Facility | | $1,288.25 | $2,818.38 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,754.23 / $5,248.07 / $5,248.07
| Facility | 62 | $2,754.23 | $5,248.07 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $446.68 / $831.76 / $831.76
| Facility | AS | $446.68 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,025.60 / $22,908.68
| Facility | | $3,388.44 | $6,025.60 | $22,908.68 |