- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,746.37 / $5,079.00 / $24,049.41
| Facility | | $1,746.37 | $5,079.00 | $24,049.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,059.71 / $2,059.71 / $2,059.71
| Facility | | $2,059.71 | $2,059.71 | $2,059.71 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,274.33 / $1,274.33 / $1,274.33
| Facility | 62 | $1,274.33 | $1,274.33 | $1,274.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.90 / $203.90 / $203.90
| Facility | AS | $203.90 | $203.90 | $203.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,926.63 / $39,586.14 / $113,068.53
| Facility | | $4,926.63 | $39,586.14 | $113,068.53 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,195.29 / $2,195.29 / $2,195.29
| Facility | 22 | $2,195.29 | $2,195.29 | $2,195.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,569.00 / $5,350.00 / $22,357.91
| Facility | | $1,569.00 | $5,350.00 | $22,357.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,059.71 / $2,059.71 / $2,059.71
| Facility | | $2,059.71 | $2,059.71 | $2,059.71 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,274.33 / $1,274.33 / $1,274.33
| Facility | 62 | $1,274.33 | $1,274.33 | $1,274.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.90 / $203.90 / $203.90
| Facility | AS | $203.90 | $203.90 | $203.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.76 / $1,769.18 / $1,769.18
| Facility | | $1,708.76 | $1,769.18 | $1,769.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,742.00 / $6,742.00 / $12,841.00
| Facility | | $3,742.00 | $6,742.00 | $12,841.00 |