- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $8,709.64 / $14,125.38
| Facility | | $5,623.41 | $8,709.64 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $15,488.17 / $30,199.52
| Facility | | $11,748.98 | $15,488.17 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $31,622.78 / $31,622.78
| Facility | | $31,622.78 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,818.38 / $22,908.68
| Facility | | $1,584.89 | $2,818.38 | $22,908.68 |
- 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
- Professional
- Modifier
- Low / Median / High Price
- $3,311.31 / $4,073.80 / $5,754.40
| Professional | | $3,311.31 | $4,073.80 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $31,622.78 / $31,622.78
| Facility | | $31,622.78 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $36,307.81
| Facility | | $10,715.19 | $16,218.10 | $36,307.81 |