- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.09 / $3,908.01 / $20,928.72
| Facility | | $652.09 | $3,908.01 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.09 / $1,145.97 / $2,172.51
| Facility | | $652.09 | $1,145.97 | $2,172.51 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,131.72 / $2,142.04 / $2,142.04
| Facility | 62 | $1,131.72 | $2,142.04 | $2,142.04 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.08 / $342.73 / $342.73
| Facility | AS | $181.08 | $342.73 | $342.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.90 / $1,647.72 / $2,333.87
| Facility | | $864.90 | $1,647.72 | $2,333.87 |
- 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 |