- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.36 / $2,505.00 / $6,432.00
| Facility | | $687.36 | $2,505.00 | $6,432.00 |
- 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
- $550.42 / $550.42 / $550.42
| Facility | | $550.42 | $550.42 | $550.42 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $337.64 / $337.64 / $337.64
| Facility | 62 | $337.64 | $337.64 | $337.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.02 / $54.02 / $54.02
| Facility | AS | $54.02 | $54.02 | $54.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,402.58 / $9,402.58 / $9,402.58
| Facility | | $9,402.58 | $9,402.58 | $9,402.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.36 / $2,667.00 / $7,197.00
| Facility | | $687.36 | $2,667.00 | $7,197.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $550.42 / $550.42 / $550.42
| Facility | | $550.42 | $550.42 | $550.42 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $337.64 / $337.64 / $337.64
| Facility | 62 | $337.64 | $337.64 | $337.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.02 / $54.02 / $54.02
| Facility | AS | $54.02 | $54.02 | $54.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.58 / $471.70 / $471.70
| Facility | | $464.58 | $471.70 | $471.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.00 / $650.00 / $3,742.00
| Facility | | $162.00 | $650.00 | $3,742.00 |