- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,309.99 / $8,510.00
| Facility | | $1,456.00 | $4,309.99 | $8,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,271.00 / $9,962.39 / $15,740.47
| Facility | | $6,271.00 | $9,962.39 | $15,740.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,793.88 / $2,633.14 / $22,392.22
| Facility | | $1,793.88 | $2,633.14 | $22,392.22 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $2,770.67 / $5,209.43 / $5,209.43
| Facility | 62 | $2,770.67 | $5,209.43 | $5,209.43 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $443.31 / $833.51 / $833.51
| Facility | AS | $443.31 | $833.51 | $833.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,412.00 / $14,511.00 / $24,508.10
| Facility | | $3,412.00 | $14,511.00 | $24,508.10 |