- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.05 / $3,908.01 / $13,841.56
| Facility | | $415.05 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $415.05 / $726.34 / $1,775.00
| Facility | | $415.05 | $726.34 | $1,775.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $722.54 / $1,377.59 / $1,377.59
| Facility | 62 | $722.54 | $1,377.59 | $1,377.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $115.61 / $220.41 / $220.41
| Facility | AS | $115.61 | $220.41 | $220.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.10 / $1,059.68 / $1,526.72
| Facility | | $564.10 | $1,059.68 | $1,526.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |