- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.42 / $705.42 / $2,168.00
| Facility | | $705.42 | $705.42 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $582.82 / $1,270.02
| Facility | | $0.98 | $582.82 | $1,270.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,697.13 / $2,407.98 / $5,792.72
| Facility | | $1,697.13 | $2,407.98 | $5,792.72 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $531.50 / $531.50 / $531.50
| Facility | 62 | $531.50 | $531.50 | $531.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.04 / $85.04 / $85.04
| Facility | AS | $85.04 | $85.04 | $85.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,542.84 / $2,201.46 / $4,561.20
| Facility | | $1,542.84 | $2,201.46 | $4,561.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.42 / $1,192.16 / $1,969.26
| Facility | | $705.42 | $1,192.16 | $1,969.26 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $1,139.24 / $1,139.24 / $1,139.24
| Facility | 62 | $1,139.24 | $1,139.24 | $1,139.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $182.28 / $182.28 / $182.28
| Facility | AS | $182.28 | $182.28 | $182.28 |
- 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 |