- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.30 / $702.30 / $2,168.00
| Facility | | $702.30 | $702.30 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $579.08 / $3,612.26
| Facility | | $0.98 | $579.08 | $3,612.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,689.55 / $2,397.23 / $5,766.86
| Facility | | $1,689.55 | $2,397.23 | $5,766.86 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $526.61 / $526.61 / $526.61
| Facility | 62 | $526.61 | $526.61 | $526.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.26 / $84.26 / $84.26
| Facility | AS | $84.26 | $84.26 | $84.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.96 / $2,191.64 / $4,540.84
| Facility | | $1,535.96 | $2,191.64 | $4,540.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.30 / $1,186.89 / $1,966.00
| Facility | | $702.30 | $1,186.89 | $1,966.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,131.72 / $1,131.72 / $1,131.72
| Facility | 62 | $1,131.72 | $1,131.72 | $1,131.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.08 / $181.08 / $181.08
| Facility | AS | $181.08 | $181.08 | $181.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |